Comparison of three lymph node staging schemes for predicting outcome in patients with gastric cancer
- 15 January 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 100 (4), 505-514
- https://doi.org/10.1002/bjs.9014
Abstract
Background Several node staging schemes have been proposed for gastric cancer. The optimal system remains controversial. Methods Patients with gastric cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database, and a Chinese patient cohort was used for independent validation. The prognostic performance of three node staging schemes was compared, involving a number-based scheme (pN), ratio-based scheme (rN) and log odds of positive lymph nodes scheme (LODDS). Results There were 12 443 patients in the SEER database and 866 in the Chinese cohort. LODDS provided better discriminatory capacity and higher predictive accuracy than either pN or rN, for patients with gastric cancer in both the SEER database and the Chinese cohort. The multivariable model using the LODDS classification was significantly more predictive than the pN classification. LODDS suffered much less from stage migration and was able efficiently to discriminate the heterogeneity for patients with no nodes involved or all nodes involved, whereas the pN and rN schemes could not. Conclusion LODDS showed a clear prognostic superiority over both pN and rN schemes. It could serve as an important reference for the tumour node metastasis (TNM) node classification.This publication has 28 references indexed in Scilit:
- Advanced Hepatocellular Carcinoma: Which Staging Systems Best Predict Prognosis?Journal of Clinical Oncology, 2010
- Log odds of positive lymph nodesCancer, 2010
- A Common Misuse of Stepwise Regression in Studies of Ratio of Metastatic Lymph Nodes for Gastric CancerAnnals of Surgical Oncology, 2008
- Prognosis of advanced hepatocellular carcinoma: comparison of three staging systems in two French clinical trialsAnnals of Oncology, 2008
- The Ratio Between Metastatic and Examined Lymph Nodes (N Ratio) Is an Independent Prognostic Factor in Gastric Cancer Regardless of the Type of LymphadenectomyAnnals of Surgery, 2007
- A new measure of prognostic separation in survival dataStatistics in Medicine, 2004
- Predictive accuracy and explained variationStatistics in Medicine, 2003
- Influence of the number of lymph nodes examined on staging of gastric cancerBritish Journal of Surgery, 2001
- Clinicopathologic characteristics and prognostic factors in 10 783 patients with gastric cancerGastric Cancer, 1998
- Martingale-based residuals for survival modelsBiometrika, 1990