scholarly journals Development and validation of prognostic factors for lymph node metastasis in endometrial cancer: A SEER analysis

2020 ◽  
Author(s):  
Xingchen Li ◽  
Yuan Cheng ◽  
Yangyang Dong ◽  
Jingyi Zhou ◽  
Xiao Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Predictive Accuracy ◽  
Large Population ◽  
Multivariate Logistic Regression Analysis ◽  
Myometrial Invasion ◽  
Net Benefit ◽  
Clinical Value ◽  
Node Metastasis

Abstract Objective: The purpose of this study was to develop and validate a nomogram that can be used to predict lymph node metastasis (LNM) in patients with endometrial carcinoma (EC). Methods: Clinical data of EC patients diagnosed between 2004 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results Program (SEER) registry. The nomogram was constructed using independent risk factors chosen using a multivariate logistic regression analysis. Accuracy was validated for both groups using discrimination analysis and calibration curves. The predictive accuracy and clinical value of the nomogram and Mayo criteria were compared using decision curve analysis (DCA). Results: The final study group consisted of 63,836 women that met specific inclusion criteria. The factors that were identified in the multivariate analysis to be notable predictors of LNM were age, tumor size, histological type, cervical stromal invasion, tumor grade, and myometrial invasion. These risk factors were included in the nomogram. Discriminations of the nomogram and Mayo criteria were 0.848 (95% CI: 0.843-0.853) and 0.806 (95%CI: 0.801-0.812), respectively. In the validation group, the AUC values were 0.847 (95%CI: 0.840-0.857) and 0.804 (95%CI: 0.796-0.813) for the nomogram and the Mayo criteria, respectively ( P <0.01). Calibration plots showed that training and validation cohorts were well-calibrated. DCA revelaed that by using the nomogram always had a positive net benefit compared to using the Mayo criteria. Conclusions: A nomogram was developed to predict LNM in EC patients based on a large population-based analysis. The nomogram showed good performance for predicting LNM in patients with EC.

scholarly journals Development and Validation a Nomogram for Predicting the Third Station Lymph Node Metastasis in Early Gastric Cancer

2021 ◽  
Author(s):  
Xiaoxiao Wang ◽  
Cong Li ◽  
Mengjie Fang ◽  
Liwen Zhang ◽  
Lianzhen Zhong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Validation Cohort ◽  
Predictive Accuracy ◽  
Clinical Risk Factors ◽  
Node Metastasis ◽  
Clinical Risk

Abstract Background:This study aimed to evaluate the value of radiomic nomogram in predicting lymph node metastasis in T1-2 gastric cancer according to the No. 3 station lymph nodes.Methods:A total of 159 T1-2 gastric cancer (GC) patients who had undergone surgery with lymphadenectomy between March 2012 and November 2017 were retrospectively collected and divided into a primary cohort (n = 80) and a validation cohort (n = 79). Radiomic features were extracted from both tumor region and No. 3 station lymph nodes (LN) based on computed tomography (CT) images per patient. Then, key features were selected using minimum redundancy maximum relevance algorithm and fed into two radiomic signatures, respectively. Meanwhile, the predictive performance of clinical risk factors was studied. Finally, a nomogram was built by merging radiomic signatures and clinical risk factors and evaluated by the area under the receiver operator characteristic curve (AUC) as well as decision curve.Results: Two radiomic signatures, reflecting phenotypes of the tumor and LN respectively, were significantly associated with LN metastasis. A nomogram incorporating two radiomic signatures and CT-reported LN metastasis status showed good discrimination of LN metastasis in both the primary cohort (AUC: 0.915; 95% confidence interval [CI]: 0.832-0.998) and validation cohort (AUC: 0.908; 95%CI: 0.814-1.000). The decision curve also indicated its potential clinical usefulness.Conclusions:The nomogram received favorable predictive accuracy in predicting No.3 station LN metastasis in T1-2 GC, and could assist the choice of therapy.

scholarly journals Nomogram Based on Preoperative Clinical Characteristics to Predict the Risk of Lymph Node Metastasis in Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Rongyu Wei ◽  
Shuqun Li ◽  
Liying Ren ◽  
Junxiong Yu ◽  
Weijia Liao
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Logistic Regression ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Clinical Characteristics ◽  
Predictive Accuracy ◽  
Hepatitis B Surface Antigen ◽  
Area Under The Curve ◽  
Node Metastasis

Abstract Background: There are limitations in judging the occurrence of lymph node metastasis (LNM) in hepatocellular carcinoma (HCC) before surgery. The purpose of this study was to establish a preoperative nomogram for predicting the risk of LNM in HCC and to explore its clinical utility.Methods: A total of 195 HCC patients undergoing radical hepatectomy were retrospectively analyzed. According to the presence or absence of LNM, the patients were divided into two groups, and the clinical characteristics of the two groups were compared. Risk factors for LNM were assessed based on logistic regression, and a nomogram was established. The receiver operating characteristic (ROC) curve was used to calculate area under the curve (AUC) of the logistic regression model, and the predictive accuracy of the nomogram was evaluated by the concordance index (C-index). The clinical efficacy of the nomogram was detected by decision curve analysis (DCA).Results: Logistic analysis revealed hepatitis B surface antigen (HBsAg) (HR = 3.50, 95% CI, 1.30-9.42, P = 0.013), globulin (HR = 2.46, 95% CI, 1.05-5.75, P = 0.039), neutrophil to lymphocyte ratio (NLR) (HR = 7.64, 95% CI, 3.22-18.11, P < 0.001) and tumor size (HR = 3.86, 95% CI, 1.26-11.88 P = 0.018) were independent risk factors for lymph node metastasis in HCC. The nomogram was established based on the above 4 variables, and the AUC was 0.835 (95% CI, 0.780-0.890). The calibration curve showed that the model has good predictive ability, and DCA indicates good predictive effect.Conclusions: The nomogram established by analyzing the preoperative clinical characteristics is a simple tool that can predict the risk of lymph node metastasis in HCC patients and guide clinicians to make better clinical decisions.

scholarly journals Risk Factors for Cervical Lymph Node Metastasis of Papillary Thyroid Microcarcinoma: A Single-Center Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Feng Cheng ◽  
Yanyan Chen ◽  
Lei Zhu ◽  
Bin Zhou ◽  
Yonghong Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Multivariate Logistic Regression Analysis ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma ◽  
Independent Risk Factors

Objective. To identify the clinicopathological features correlated to lymph node metastasis (LNM) in patients with papillary thyroid microcarcinoma (PTMC). Methods. Clinical data of 785 PTMC patients who underwent surgical treatment at the Lishui Municipal Central Hospital from September 2008 to December 2017 were retrospectively analyzed. Clinical and pathological risk factors for lymph node metastasis (LNM), central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) were analyzed. Results. LNM was found in 236 (30.2%) patients. Multivariate logistic regression analysis revealed that in PTMC, male gender, age<55 years, tumor size>5 mm, bilateral lesions, and extrathyroidal extension were independent risk factors for LNM in general and for CLNM. For LLNM, tumor size>5 mm, multifocal lesions, and extrathyroidal extension were independent risk factors. Conclusions. Identification of risk factors for cervical LNM could assist individualization of clinical management for PTMC.

scholarly journals Predictive Nomogram and Risk Factors for Lymph Node Metastasis in Bladder Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Zijian Tian ◽  
Lingfeng Meng ◽  
Xin Wang ◽  
Tongxiang Diao ◽  
Maolin Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Tumor Grade ◽  
Lymph Node Status ◽  
Node Metastasis ◽  
Independent Risk Factors

Lymph node metastasis (LNM) is an important prognostic factor for bladder cancer (BCA) and determines the treatment strategy. This study aimed to determine related clinicopathological factors of LNM and analyze the prognosis of BCA. A total of 10,653 eligible patients with BCA were randomly divided into training or verification sets using the 2004–2015 data of the Surveillance, Epidemiology, and End Results database. To identify prognostic factors for the overall survival of BCA, we utilized the Cox proportional hazard model. Independent risk factors for LNM were evaluated via logistic regression analysis. T-stage, tumor grade, patient age and tumor size were identified as independent risk factors for LNM and were used to develop the LNM nomogram. The Kaplan-Meier method and competitive risk analyses were applied to establish the influence of lymph node status on BCA prognosis. The accuracy of LNM nomogram was evaluated in the training and verification sets. The areas under the receiver operating characteristic curve (AUC) showed an effective predictive accuracy of the nomogram in both the training (AUC: 0.690) and verification (AUC: 0.704) sets. In addition, the calibration curve indicated good consistency between the prediction of deviation correction and the ideal reference line. The decision curve analysis showed that the nomogram had a high clinical application value. In conclusion, our nomogram displayed high accuracy and reliability in predicting LNM. This could assist the selection of the optimal treatment for patients.

Clinicopathological Risk Factors for Pelvic Lymph Node Metastasis in Clinical Early-Stage Endometrioid Endometrial Adenocarcinoma

2012 ◽  
Vol 22 (8) ◽  
pp. 1373-1377 ◽  
Author(s):  
Chuyao Zhang ◽  
Chao Wang ◽  
Weiwei Feng
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Predictive Value ◽  
Early Stage ◽  
Endometrial Adenocarcinoma ◽  
Myometrial Invasion ◽  
Node Metastasis ◽  
Deep Myometrial Invasion ◽  
Metastasis Rate

ObjectiveTo identify the clinicopathological risk factors for pelvic lymph node (PLN) metastasis and to evaluate the predictive significance of these factors for lymphadenectomy in clinical early-stage endometrioid endometrial adenocarcinoma (EEA).MethodsSix hundred and twenty-one patients with clinical early-stage EEA (tumor confined to uterus, diagnosed preoperatively or intraoperatively) who underwent hysterectomy plus bilateral salpingo-oophorectomy plus pelvic and/or para-aortic lymphadenectomy between 1989 and 2006 in the Obstetrics and Gynecology Hospital of Fudan University were retrieved. The predictive value of the risk factors for PLN metastasis was analyzed.ResultsThe positive PLN metastasis rate was 3.9%. The 5-year disease-related mortality rate in the positive PLN metastasis group was 25%, whereas the rate in the negative group was 0.8%. The positive PLN metastasis rates were higher in patients with higher-grade tumors, deep myometrial invasion, cervical stromal involvement, and lymphovascular space involvement (LVSI). The sensitivity and specificity of old age (≥60 years), grade 3, cancer deep myometrial invasion, cervical stromal involvement, and LVSI in predicting the PLN metastasis were 25.0%, 41.7%, 70.8%, 20.8%, and 41.7%; and 79.1%, 88.4%, 85.6%, 95.6%, and 94.5%, respectively. The multivariate analysis revealed that the deep myometrial invasion and LVSI were independent risk factors for lymph node metastasis. Combined with these 2 factors as the diagnostic criteria, the negative predictive value and specificity were 97.3% and 89.1%, respectively.ConclusionThe patients with clinical early-stage EEA with PLN metastasis showed worse prognoses, although the metastasis rate was low. The deep myometrial invasion and LVSI combination were superior predictive criteria for the PLN metastasis. An accurate evaluation of these factors, both preoperatively or intraoperatively, will be beneficial to predict PLN metastasis and guide the operation.

scholarly journals The Role of Lymphadenectomy in Surgical Staging of Endometrial Cancer

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Nikki L. Neubauer ◽  
John R. Lurain
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Myometrial Invasion ◽  
Surgical Staging ◽  
Node Dissection ◽  
Node Metastasis ◽  
Gynecology And Obstetrics

Surgical staging, including lymph node sampling, for endometrial cancer was adopted by the International Federation of Gynecology and Obstetrics (FIGO) in 1988 based on reports demonstrating diagnostic and therapeutic advantages. This review focuses on the incidence of lymph node metastasis, risk factors for lymph node involvement, the effect of lymph node metastasis on prognosis, the therapeutic effect and diagnostic usefulness of lymphadenectomy, risks of lymph node dissection, and future directions in surgical staging of endometrial cancer. Surgical staging identifies most patients with extrauterine disease as well as uterine risk factors for recurrence, thereby allowing for a more informed approach to postoperative adjuvant therapy. Lymphadenectomy as a part of surgical staging is not required in patients assessed intraoperatively to be at low risk for lymph node metastasis (<2 cm grade 1 tumors with superficial myometrial invasion), however, a systematic lymph node dissection should be performed in most other patients with endometrial cancer. In the future, molecular markers may be useful to predict preoperatively tumor aggressiveness and lymph node metastasis. It is hoped that an approach of surgical staging with selective lymph node dissection will improve survival and spare patients additional surgical complications or unnecessary postoperative exposure to radiation and/or chemotherapy.

scholarly journals A nomogram to predict lymph node metastasis risk for early esophageal squamous cell carcinoma

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaofeng Duan ◽  
Xiaobin Shang ◽  
Jie Yue ◽  
Zhao Ma ◽  
Chuangui Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Derivation Cohort ◽  
Node Metastasis

Abstract Background A nomogram was developed to predict lymph node metastasis (LNM) for patients with early-stage esophageal squamous cell carcinoma (ESCC). Methods We used the clinical data of ESCC patients with pathological T1 stage disease who underwent surgery from January 2011 to June 2018 to develop a nomogram model. Multivariable logistic regression was used to confirm the risk factors for variable selection. The risk of LNM was stratified based on the nomogram model. The nomogram was validated by an independent cohort which included early ESCC patients underwent esophagectomy between July 2018 and December 2019. Results Of the 223 patients, 36 (16.1%) patients had LNM. The following three variables were confirmed as LNM risk factors and were included in the nomogram model: tumor differentiation (odds ratio [OR] = 3.776, 95% confidence interval [CI] 1.515–9.360, p = 0.004), depth of tumor invasion (OR = 3.124, 95% CI 1.146–8.511, p = 0.026), and tumor size (OR = 2.420, 95% CI 1.070–5.473, p = 0.034). The C-index was 0.810 (95% CI 0.742–0.895) in the derivation cohort (223 patients) and 0.830 (95% CI 0.763–0.902) in the validation cohort (80 patients). Conclusions A validated nomogram can predict the risk of LNM via risk stratification. It could be used to assist in the decision-making process to determine which patients should undergo esophagectomy and for which patients with a low risk of LNM, curative endoscopic resection would be sufficient.

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