■新辅助治疗导致阳性淋巴结和检查淋巴结(ELN)减少,这可能会影响淋巴结分期的评估和术后治疗。我们的目的是比较淋巴结比率(LNR)的分期系统,淋巴结的正对数比(LODDS),阴性淋巴结(NLN),新辅助治疗后胃腺癌患者的AJCCypN分期为8期。
■数据来自监测,流行病学,和最终结果数据库和1,551例接受新辅助治疗和根治性手术的胃腺癌患者被纳入。Harrell的一致性指数,接收机工作曲线,似然比检验,和Akaike信息标准用于比较不同分期系统的预测能力。
■在1,551名患者中,ELN<16患者为689例(44.4%),淋巴结阴性患者占395例(25.5%)。当被视为分类变量时,LNR有更好的鉴别力,更高的同质性,与其他舞台系统相比,CSS和OS的模型适应性更好,无论ELN的地位如何。当被视为连续变量时,LODDS优于其他CSS。此外,淋巴结阴性患者的NLN分期系统优于其他分期系统。
■LNR比ypN具有更好的预测性能,LODDS和NLN分期系统,无论ELN的状态如何,当被视为分类变量时,而当被视为连续变量时,LOODS成为CSS的更好预测因子。在淋巴结阴性的患者中,NLN可能是评估预后的可行选择。在临床预后评估中,LNR和NLN的组合应被视为用户友好的方法。
UNASSIGNED: Neoadjuvant treatment leads in a reduction in positive lymph nodes and examined lymph nodes (ELN), which may affect assessment of lymph node staging and postoperative treatment. We aimed to compare the staging systems of lymph node ratio (LNR), the positive logarithm ratio of lymph nodes (LODDS), negative lymph nodes (NLN), and the 8th AJCC ypN stage for patients with gastric adenocarcinoma after neoadjuvant therapy.
UNASSIGNED: Data was collected from the Surveillance, Epidemiology, and End Results database and 1,551 patients with gastric adenocarcinoma who underwent neoadjuvant therapy and radical surgery were enrolled. Harrell\'s concordance index, the Receiver Operative Curve, the likelihood ratio test, and the Akaike information criterion were used to compare the predictive abilities of the different staging systems.
UNASSIGNED: Among the 1,551 patients, 689 (44.4%) had ELN < 16 and node-negative patients accounted for 395 (25.5%). When regarded as the categorical variable, LNR had better discrimination power, higher homogeneity, and better model fitness for CSS and OS compared to other stage systems, regardless of the status of ELN. When regarded as the continuos variable, LODDS outperformed others for CSS. Furthermore, the NLN staging system performed superior to others in node-negative patients.
UNASSIGNED: LNR had a better predictive performance than ypN, LODDS and NLN staging systems regardless of the status of ELN when regarded as the categorical variable, whereas LOODS became the better predictive factor for CSS when regarded as the continuos variable. In node-negative patients, NLN might be a feasible option for evaluating prognosis. A combination of LNR and NLN should be considered as user-friendly method in the clinical prognostic assessment.