Comparison of Four Lymph Node Stage Methods for Predicting the Prognosis of Distal Cholangiocarcinoma Patients After Surgery

BackgroundThe metastatic status of regional lymph nodes is an effective risk factor for the prognosis of distal cholangiocarcinoma (dCCA). But existing lymph node staging is not accurate enough and is susceptible to interference. This study aims to explore the predictive ability of the log odds of positive lymph nodes (LODDS) staging system of dCCA compared with existing lymph node staging systems.MethodsA total of 928 dCCA patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database as the training cohort, and 207 dCCA patients from West China Hospital who underwent surgery were reviewed as the validation cohort. The least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression were conducted to identify the most meaningful factors relevant to prognosis. The performance of four lymph node stage systems was compared by a model-based approach.ResultAge at diagnosis, pathological grade, American Joint Committee on Cancer (AJCC) tumor 7th T stage, tumor size, radiotherapy, chemotherapy, and lymph node stage system were independent prognostic factors. The model with the LODDS system had a better model fit with the highest C-index (0.679) and 1-/3-/5- area under the receiver operating characteristic curve (AUC) (0.739/0.671/0.658) as well as the lowest Akaike information criterion (AIC) (5,020.52). External validation results from 207 dCCA patients showed a C-index of 0.647 and 1-/3-/5-AUC of 0.740/0.683/0.589. Compared with the lymph node ratio (LNR), AJCC 8th N system, and 7th N system, the 5-year net reclassification improvement (NRI) of the LODDS system was 0.030 (95% CI: −0.079 to 0.147), 0.042 (95% CI: −0.062 to 0.139), and 0.040 (95% CI: −0.057 to 0.146), respectively. The integrated discrimination improvement (IDI) of LODDS improved compared with the LNR model (0.016; 95% CI: −0.001 to 0.036), AJCC 8th N system (0.020; 95% CI: 0.003–0.037), and AJCC 7th N system (0.019; 95% CI: 0.002–0.036). Decision curve analysis (DCA) also shows a greater net benefit of LODDS. In lymph node-negative patients, LODDS reveals a positive linear relationship with the hazard ratio (HR). The stage capacity of LODDS in a subgroup analysis stratified by examined lymph node number (ELNN) was consistent.ConclusionsThe LODDS lymph node stage system has superior predictive performance as compared with the LNR, AJCC 7th, and 8th lymph node stage systems. Meanwhile, LODDS has a more detailed staging ability and good stability.

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Evaluation of Lymph Node Staging Systems as Independent Prognosticators in Remnant Gastric Cancer Patients with an Insufficient Number of Harvested Lymph Nodes

Annals of Surgical Oncology ◽

10.1245/s10434-020-09433-2 ◽

2021 ◽

Cited By ~ 1

Author(s):

Kazuki Kano ◽

Takanobu Yamada ◽

Kouji Yamamoto ◽

Keisuke Komori ◽

Hayato Watanabe ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Cancer Patients ◽

Lymph Node Staging ◽

Remnant Gastric Cancer ◽

Staging Systems ◽

Gastric Cancer Patients ◽

Insufficient Number

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Comparison of three lymph node staging systems in evaluating the prognosis of patients with pT3 esophageal squamous cell carcinoma

Scientific Reports ◽

10.1038/s41598-020-74327-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Di-tian Liu ◽

Lin-shuo Wang ◽

Yu-ping Chen ◽

Shao-bin Chen

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Esophageal Squamous Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Squamous Cell ◽

Staging System ◽

Lymph Node Staging ◽

Staging Systems ◽

Positive Lymph Nodes

Abstract To explore the prognostic value of three lymph node staging systems, including number of positive lymph nodes (pN), lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS), in patients with pT3 stage esophageal squamous cell carcinoma (ESCC). Data from 1667 patients with pT3 stage ESCC who underwent surgical resection were reviewed. The log-rank test was used to assess the differences in overall survival (OS) between groups. Multivariate analysis was performed to identify independent prognostic factors. The receiver operating characteristic curve was used to assess the prognostic accuracy of the three staging methods. The median survival time for the entire group was 48.0 months, and the 1-, 3- and 5-year OS rates were 83.9%, 55.1% and 66.6%, respectively. All three lymph node staging systems were significantly correlated with OS in univariate and multivariate analyses. However, LNR and LODDS staging systems could more accurately predict survival than the pN staging system in patients with < 15 lymph nodes dissected, while LODDS have the best prognostic homogeneity. All three staging systems could be used for prognostic assessment in pT3 stage ESCC. But LODDS staging system might be superior to the others due to its prognostic homogeneity.

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Comparison of different lymph node staging systems in patients with positive lymph nodes in oral squamous cell carcinoma

Oral Oncology ◽

10.1016/j.oraloncology.2020.105146 ◽

2021 ◽

Vol 114 ◽

pp. 105146

Author(s):

Nan-Chin Lin ◽

I-Hsien Su ◽

Jui-Ting Hsu ◽

Yu-Jun Chang ◽

Kuo-Yang Tsai

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Oral Squamous Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Squamous Cell ◽

Lymph Node Staging ◽

Staging Systems ◽

Positive Lymph Nodes

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Comparison of three lymph node staging systems in evaluating the prognosis of patients with pT3 esophageal squamous cell carcinoma

10.21203/rs.3.rs-38767/v1 ◽

2020 ◽

Author(s):

Di-tian Liu ◽

Lin-shuo Wang ◽

Yu-ping Chen ◽

Shao-bin Chen

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Esophageal Squamous Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Squamous Cell ◽

Staging System ◽

Lymph Node Staging ◽

Staging Systems ◽

Positive Lymph Nodes

Abstract Background: To explore the prognostic value of three lymph node staging systems, including number of positive lymph nodes (pN), lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS), in patients with pT3 stage esophageal squamous cell carcinoma (ESCC).Methods: Data from 1667 patients with pT3 stage ESCC who underwent surgical resection were reviewed. The log-rank test was used to assess the differences in overall survival (OS) between groups. Multivariate analysis was performed to identify independent prognostic factors. The receiver operating characteristic curve was used to assess the prognostic accuracy of the three staging methods.Results: The median survival time for the entire group was 48.0 months, and the 1-, 3- and 5-year OS rates were 83.9%, 55.1% and 66.6%, respectively. All three lymph node staging systems were significantly correlated with OS in univariate and multivariate analyses. However, LNR and LODDS staging systems could more accurately predict survival than the pN staging system in patients with < 15 lymph nodes dissected, while LODDS have the best prognostic homogeneity.Conclusions: All three staging systems could be used for prognostic assessment in pT3 stage ESCC. But LODDS staging system might be superior to the others due to its prognostic homogeneity.

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Comparison of 4 lymph node staging systems for the prognostic prediction of esophagogastric junction adenocarcinoma with ≤15 retrieved lymph nodes

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2021.11.133 ◽

2021 ◽

Author(s):

Yuesheng Yang ◽

Jiabin Zheng ◽

Yong Li

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Esophagogastric Junction ◽

Lymph Node Staging ◽

Esophagogastric Junction Adenocarcinoma ◽

Staging Systems ◽

Prognostic Prediction

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Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer staging: early experience in Brazil,

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132015000100004 ◽

2015 ◽

Vol 41 (1) ◽

pp. 23-30 ◽

Cited By ~ 5

Author(s):

Viviane Rossi Figueiredo ◽

Paulo Francisco Guerreiro Cardoso ◽

Márcia Jacomelli ◽

Sérgio Eduardo Demarzo ◽

Addy Lidvina Mejia Palomino ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Cancer Staging ◽

Accurate Method ◽

Needle Aspiration ◽

Endobronchial Ultrasound ◽

Lymph Node Staging ◽

Ultrasound Guided ◽

Transbronchial Needle Aspiration

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, safe and accurate method for collecting samples from mediastinal and hilar lymph nodes. This study focused on the initial results obtained with EBUS-TBNA for lung cancer and lymph node staging at three teaching hospitals in Brazil. Methods: This was a retrospective analysis of patients diagnosed with lung cancer and submitted to EBUS-TBNA for mediastinal lymph node staging. The EBUS-TBNA procedures, which involved the use of an EBUS scope, an ultrasound processor, and a compatible, disposable 22 G needle, were performed while the patients were under general anesthesia. Results: Between January of 2011 and January of 2014, 149 patients underwent EBUS-TBNA for lymph node staging. The mean age was 66 ± 12 years, and 58% were male. A total of 407 lymph nodes were sampled by EBUS-TBNA. The most common types of lung neoplasm were adenocarcinoma (in 67%) and squamous cell carcinoma (in 24%). For lung cancer staging, EBUS-TBNA was found to have a sensitivity of 96%, a specificity of 100%, and a negative predictive value of 85%. Conclusions: We found EBUS-TBNA to be a safe and accurate method for lymph node staging in lung cancer patients.

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Lymph node status assessment in head and neck squamous cell carcinoma in patients with clinically non palpable lymph nodes: Meta-analysis

QJM ◽

10.1093/qjmed/hcab094.009 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hany Riad ◽

Samer Ibrahim ◽

Amr Gouda ◽

Ossama Mustafa ◽

Heba Mohamed

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Meta Analysis ◽

Lymph Node Status ◽

Lymph Node Staging ◽

Pet Ct

Abstract Background The most important prognostic factor in squamous cell carcinoma of the head and neck (HNSCC) is the presence or absence of clinically involved neck nodes. The presence of metastases in a lymph node is said to reduce the 5-years survival rate by about 50%. The appropriate diagnosis of the presence of metastatic node is very important for the management of HNSCC Aim To compare difTerent diagnostic modalities for assessment of the clinically non palpable lymph nodes in HNSCC including by meta-analysis: CT, MRI, US, USFNAC and PET/CT for the proper cervical lymph node staging. Methods Met-analysis study on patients with HNSCC of clinically non palpable lymph nodes (cN0). Results Analysis was divided in 6 groups .Each group contain analysis of one modality according to available studies per patient, per level and per lesion .US is fair test per patient and per lesion.CT is good test per patient and excellent test per lesion.MRI is poor test per patient and fair test per lesion.CT-MRl combined is fair per patient and excellent per level.PET/CT is good per patient, fair per lesion and excellent per level. USFNAC is excellent per lesion. Conclusion CT, CT-MRI combined, PET/CT and USFNAC proved to be excellent in detecting cN0.MRI was poor test in detecting cN0.US was a fair test in detecting cN0 if used alone.

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