Critical prognostic value of the log odds of negative lymph nodes/tumor size in rectal cancer patients

PURPOSE: In retrospective studies, total mesorectal excision (TME) surgery has been demonstrated to result in a reduction in the number of local recurrences of rectal cancer. Reports on improved local control after preoperative, hypofractionated radiotherapy have led to the introduction of a randomized multicenter trial to evaluate the effect of TME surgery with and without preoperative radiotherapy. Treatment with preoperative radiotherapy might have an effect on the pathologic characteristics that determine staging of rectal cancer. We investigated the occurrence of downstaging in rectal cancer patients treated with and without preoperative radiotherapy. PATIENTS AND METHODS: We analyzed the differences in tumor size, number of examined lymph nodes, tumor-node-metastasis stage, and histopathologic features in 1,321 patients entered onto a randomized trial. The trial compared preoperative radiotherapy (5 × 5 Gy) followed by TME surgery with TME surgery alone. Patients who had an interval of more than 10 days between the start of radiotherapy and surgery were excluded from analysis. RESULTS: Differences were observed in tumor size (P < .001) and total number of examined lymph nodes (P < .001). No difference in tumor or node classification was detected. The irradiated group demonstrated more poorly differentiated tumors as well as more mucinous tumors. CONCLUSION: In rectal cancer patients, short-term, preoperative radiotherapy with 5 × 5 Gy does not lead to downstaging if the interval between the start of radiotherapy and surgery does not exceed 10 days.

Download Full-text

Log odds of positive lymph nodes is a superior prognostic indicator in stage III rectal cancer patients: A retrospective analysis of 17,632 patients in the SEER database

International Journal of Surgery ◽

10.1016/j.ijsu.2016.06.002 ◽

2016 ◽

Vol 32 ◽

pp. 24-30 ◽

Cited By ~ 11

Author(s):

Ben Huang ◽

Chen Chen ◽

Mengdong Ni ◽

Shaobo Mo ◽

Guoxiang Cai ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Nodes ◽

Retrospective Analysis ◽

Cancer Patients ◽

Prognostic Indicator ◽

Stage Iii ◽

Seer Database ◽

Log Odds ◽

Positive Lymph Nodes

Download Full-text

The Log Odds of Positive Lymph Nodes Stratifies and Predicts Survival of High‐Risk Individuals Among Stage III Rectal Cancer Patients

The Oncologist ◽

10.1634/theoncologist.2015-0441 ◽

2016 ◽

Vol 21 (4) ◽

pp. 425-432 ◽

Cited By ~ 8

Author(s):

Christina W. Lee ◽

Katheryn H. Wilkinson ◽

Adam C. Sheka ◽

Glen E. Leverson ◽

Gregory D. Kennedy

Keyword(s):

Rectal Cancer ◽

High Risk ◽

Lymph Nodes ◽

Cancer Patients ◽

Stage Iii ◽

Log Odds ◽

Positive Lymph Nodes

Download Full-text

The Prognostic Value of the Number of Negative Lymph Nodes Combined with Positive Lymph Nodes in Esophageal Cancer Patients: A Propensity-Matched Analysis

Annals of Surgical Oncology ◽

10.1245/s10434-019-08083-3 ◽

2020 ◽

Vol 27 (6) ◽

pp. 2042-2050 ◽

Cited By ~ 1

Author(s):

Linghui Zhou ◽

Yang Zhao ◽

Yi Zheng ◽

Meng Wang ◽

Tian Tian ◽

...

Keyword(s):

Esophageal Cancer ◽

Lymph Nodes ◽

Cancer Patients ◽

Prognostic Value ◽

Negative Lymph Nodes ◽

Positive Lymph Nodes

Download Full-text

Large negative lymph nodes – a surrogate for immune activation in rectal cancer patients?

Pathology - Research and Practice ◽

10.1016/j.prp.2020.153106 ◽

2020 ◽

Vol 216 (9) ◽

pp. 153106

Author(s):

JE Ruisch ◽

M Kloft ◽

GE Fazzi ◽

J Melenhorst ◽

DR Magee ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Nodes ◽

Cancer Patients ◽

Immune Activation ◽

Negative Lymph Nodes

Download Full-text

The log odds of negative lymph nodes/T stage: a new prognostic and predictive tool for resected gastric cancer patients

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-021-03654-y ◽

2021 ◽

Author(s):

Jiebin Xie ◽

Yueshan Pang ◽

Xun Li ◽

Xiaoting Wu

Keyword(s):

Gastric Cancer ◽

Lymph Nodes ◽

Cancer Patients ◽

Clinicopathological Factors ◽

Predictive Tool ◽

T Stage ◽

Log Odds ◽

Gastric Cancer Patients ◽

The Impact ◽

Negative Lymph Nodes

Abstract Purpose When only the TNM classification is used to predict survival in gastric cancer (GC) patients, the impact of the degree of lymphadenectomy on the prognosis is neglected. This study aimed to establish a more effective nomogram based on the log odds of negative lymph nodes/T stage ratio (LONT) to predict survival in surgically treated GC patients. Methods The data of resected GC patients were extracted from the Surveillance, Epidemiology, and End Results Program (SEER) database. Univariate and multivariate Cox regression analyses were used to identify the significant prognostic factors. The prognostic performance was assessed using a calibration plot, concordance index (C-index), and area under the (time-dependent receiver operating characteristic) curve (AUC) to compare the predicted survival probability based on the nomogram score groups. Results The results showed LONT as an independent prognostic factor for cancer-specific survival (CSS) and overall survival (OS), independent of clinicopathological factors. After removing potential redundancy, only LONT, T stage, N stage, location and age were used in the final nomogram model. The model had a higher C-index (0.736 ± 0.012) and AUC (0.798) than the TNM staging system (0.685 ± 0.012 and 0.744). The nomogram score could predict a significant survival difference between any two adjacent groups in terms of CSS and OS. Conclusion High LONT is associated with improved survival of gastric cancer patients, independent of other clinicopathological factors. The prognostic nomogram model based on LONT could effectively predict CSS and OS for resectable GC patients.

Download Full-text