Lymph node status after resection for gallbladder adenocarcinoma: Prognostic implications of different nodal staging/scoring systems
- 13 October 2014
- journal article
- research article
- Published by Wiley in Journal of Surgical Oncology
- Vol. 111 (3), 299-305
- https://doi.org/10.1002/jso.23813
Abstract
Background and Objectives Several lymph node (LN) staging/scoring systems have been proposed to stratify the prognosis of patients with gallbladder adenocarcinoma (GBA). We sought to define the prognostic performance of the most commonly utilized LN staging/scoring systems including AJCC/UICC N stage, lymph node ratio (LNR), log odds (LODDS), and N score, among patients with GBA. Method Between 2004 and 2010, 1,124 patients with GBA were identified from the Surveillance Epidemiology and End Results (SEER) database. The discriminative ability of each LN staging/scoring system was assessed using the Akaike's Information Criterion (AIC) and the Harrell's concordance index. Results When assessed using categorical values, LNR had a modest, improved ability to discriminate patients with regard to prognosis (C‐index: 0.615; AIC: 2118.2) compared with AJCC/UICC N stage or N score and a prognostic discrimination comparable to LODDS. Among patients who had a total number of LN examined (TNLE) of 1 or 2, all the staging/scoring systems performed comparably. In contrast, among patients who had ≥4 TNLE, LODDS performed the best (C‐index: 0.613; AIC: 303.2). Conclusion The performance of the different LN staging/scoring systems varied based on the TNLE. In particular, for patients who had ≥4 TNLE, LODDS out‐performed the other staging/scoring systems. J. Surg. Oncol. 2015 111:299–305.This publication has 39 references indexed in Scilit:
- Key Factors Influencing Prognosis in Relation to Gallbladder CancerDigestive Diseases and Sciences, 2013
- Comparison of three lymph node staging schemes for predicting outcome in patients with gastric cancerBritish Journal of Surgery, 2013
- Impact of lymph node ratio as a valuable prognostic factor in gallbladder carcinoma, focusing on stage IIIB gallbladder carcinomaJournal of the Korean Surgical Society, 2013
- Assessment of lymph node status in gallbladder cancer: location, number, or ratio of positive nodesWorld Journal of Surgical Oncology, 2012
- The role of lymph node dissection in the management of prostate cancerInternational Journal of Clinical Oncology, 2011
- Regional lymphadenectomy strongly recommended in T1b gallbladder cancerWorld Journal of Gastroenterology, 2011
- Number of Positive Lymph Nodes Independently Determines the Prognosis After Resection in Patients with Gallbladder CarcinomaAnnals of Surgical Oncology, 2010
- Epidemiology of biliary tract cancers: an updateAnnals of Oncology, 2008
- Application of Akaike's information criterion (AIC) in the evaluation of linear pharmacokinetic equationsJournal of Pharmacokinetics and Biopharmaceutics, 1978
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958