scholarly journals A “perfect” lymph node staging system requires a “perfect” surgery

2016 ◽  
Vol 1 ◽  
pp. 10-10 ◽  
Author(s):  
Laura Ruspi ◽  
Federica Galli ◽  
Francesco Frattini ◽  
Chiara Peverelli ◽  
Giuseppe Di Rocco ◽  
...  
Keyword(s):  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging

Proposal of a new lymph node staging system for gastric cancer: study from two institutions in China

2014 ◽  
Vol 31 (10) ◽  
Author(s):  
Jizhun Zhang ◽  
Kewei Jiang ◽  
Yong Liu ◽  
Yingjiang Ye ◽  
Liang Lv ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
Cancer Study ◽  
Gastric Cancer Study

Comparison of lymph node staging system in gastric cancer using time-dependent ROC analysis with Harrell’s concordance index.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 12-12
Author(s):  
Etsuro Bando ◽  
Norihiko Sugisawa ◽  
Masanori Tokunaga ◽  
Yutaka Tanizawa ◽  
Taiichi Kawamura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Survival Rate ◽  
Roc Analysis ◽  
Staging System ◽  
Time Dependent ◽  
Lymph Node Staging ◽  
Anatomical Location ◽  
Node Negative ◽  
Staging Systems

12 Background: The aim this study was to clarify what the most informative pathologic lymph node staging system in gastric cancer is, by using time-dependent receiver operating characteristic (ROC) analysis with Harrell’s concordance (c) index. Methods: This study enrolled 2747 primary gastric cancer patients, without prior chemotherapy, who underwent R0 or R1 macroscopically curative resection. We calculated concordance indices of different 3 nodal staging systems (anatomical level based on JPN 13th edition vs. numbers of metastatic nodes based upon TNM 7th edition vs. ratio of metastatic nodes; derived from Yu’s definition {Yu et al. Br J Surg;1997,N0:0, N1;0-0.1, N2;0.1-0.25, N3;0.25-}) for survival. Results: (Anatomical level) Harrell’s c-index was 0.754 with 5-year survival rate of N0; 93%, N1; 73%, N2; 51%, N3; 19%. C-index without node-negative patients was 0.628. (Numbers of positive nodes) C-index was 0.767 with 5-year survival rate of N0; 93%, N1; 81%, N2; 68%, N3; 37%. C-index without node-negative patients was 0.669. (Ratio of nodal involvement) C-index was 0.770 with 5-year survival rate of N0; 93%, N1; 80%, N2; 63%, N3; 29%. C-index without node-negative patients was 0.691, which is significantly larger than those in anatomical level or numbers of positive nodes (p<0.001, p=0.014, respectively). (Comparison of Staging System) If combined pT category with ratio grading system without pStage IA, new staging system is the significantly most informative (c-index; 0.760) than JPN 13th (c-index; 0.735) or TNM 7th (c-index; 0.742) (p=0.009, p=0.023, respectively). Conclusions: Lymph node staging system based on the conception of ratio of metastatic nodes is the most informative staging system than those with anatomical location or numbers of metastatic nodes. These results suggested that in gastric cancer pathologic staging system in next TNM classification should include the ratio of metastatic nodes.

A novel simplified approach to incorporating lymph node ratio into gastric cancer staging.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 24-24
Author(s):  
Sarah B. Fisher ◽  
Malcolm Hart Squires ◽  
Sameer H. Patel ◽  
David A. Kooby ◽  
Kenneth Cardona ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Ratio ◽  
Staging System ◽  
Cancer Staging ◽  
Lymph Node Staging ◽  
Cox Regression Analysis ◽  
Simplified Approach ◽  
Staging Systems ◽  
Node Ratio

24 Background: Previous investigators have reported on the value of lymph node ratio (LNR, defined as the number of positive nodes divided by the total number of nodes assessed) in gastric adenocarcinoma (GAC) staging. Given the complexity of previously proposed staging systems, it has not gained widespread acceptance. The aim of our study was to offer a novel simplified approach to incorporating LNR into gastric cancer staging. Methods: 131 patients who underwent curative intent resection with lymphadenectomy for GAC between 1/00-6/11 were identified. Clinicopathologic factors were assessed. Primary outcome was overall survival (OS). Results: Median age was 64 yrs, 51% were male. Median tumor size was 3.5 cm, 67% were poorly differentiated, 20% had perineural invasion, 31% had lymphovascular invasion, and 6% had a positive margin. Locoregional nodal metastases were present in 59% (n=77, N0: 41%, N1: 18%, N2: 22%, N3a: 14%, N3b: 5%). Median number of lymph nodes (LN) assessed was 15.5. Mean FU was 27.3 mos, median OS was 29.3 mos. Median LNR was 0.4 (.04-1). Patients with LNR ≥0.4 had decreased OS as compared to patients with LNR <0.4 (15.1 vs 41.5 mos, p<0.0001); the survival of patients with LNR <0.4 was similar to that of node negative pts (48 mos, p=0.882). On Cox regression analysis, LNR ≥0.4 was more strongly associated with decreased OS (HR 3.09, 95%CI: 1.81-5.26; p<0.0001) compared to the AJCC 7th edition N stage (HR 1.36, 95%CI: 1.11-1.68; p=0.004). In the subset of patients who were inadequately staged and had <16 nodes examined, a LNR ≥0.4 was associated with reduced survival compared to a LNR <0.4 (17.3 vs 41.5 mos, p=.04). Conclusions: Compared to the current lymph node staging system, a lymph node ratio using 0.4 as the cutoff may more accurately predict survival outcomes. It seems to be particularly useful in patients who have inadequate nodal assessment. This simplified approach to lymph node ratio may be a more valuable staging tool than the current AJCC nodal staging system for gastric cancer and needs to be validated.

scholarly journals Development of a novel salivary gland cancer lymph node staging system

Cancer ◽  
2018 ◽  
Vol 124 (15) ◽  
pp. 3171-3180 ◽  
Author(s):  
Katri Aro ◽  
Allen S. Ho ◽  
Michael Luu ◽  
Sungjin Kim ◽  
Mourad Tighiouart ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Lymph Node ◽  
Staging System ◽  
Salivary Gland Cancer ◽  
Lymph Node Staging

scholarly journals Prognostic Evaluation for Patients over 45 Years Old with Gallbladder Adenocarcinoma Resection: A SEER-Based Nomogram Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Pengfei Li ◽  
Lujun Song
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
Internal Validation ◽  
Gallbladder Adenocarcinoma ◽  
Low Incidence ◽  
Using Data ◽  
Patient Prognosis ◽  
Lymph Node Stage

Gallbladder adenocarcinoma is the main histopathological type of gallbladder cancer (GBC), so it is particularly important to understand its biological characteristics. Due to the low incidence of this type of cancer, there are few studies with large sample sizes. The log of positive lymph nodes (LODDS) has been evaluated by many scholars as a lymph node stage that may play a better role than the 8th edition of the American Joint Committee on Cancer (AJCC) lymph node staging system in many cancers. However, the effect of LODDS has not been proven in gallbladder adenocarcinoma. Our research aimed to identify independent prognostic factors that are closely related to overall survival (OS) in patients with gallbladder adenocarcinoma over 45 years of age using data from the Surveillance, Epidemiology and, End Results (SEER) database. All patients were randomly divided into a modeling cohort and an internal validation cohort. Seven independent prognostic factors associated with OS—age, marital status, grade, tumor size, AJCC 8th edition T stage and M stage, and LODDS—were used to build a nomogram to predict 1-, 3-, and 5-year survival. The C-index of our nomogram was 0.735 (95% CI, 0.716 to 0.754), and together with the calibration curve and ROC curve validation, the results confirmed the prediction effect of our nomogram. We believe that our nomogram will be an accurate and convenient method for patient prognosis assessment in the future.

scholarly journals A Lymph Node Staging System for Gastric Cancer: A Hybrid Type Based on Topographic and Numeric Systems

PLoS ONE ◽  
2016 ◽  
Vol 11 (3) ◽  
pp. e0149555 ◽  
Author(s):  
Yoon Young Choi ◽  
Ji Yeong An ◽  
Hitoshi Katai ◽  
Yasuyuki Seto ◽  
Takeo Fukagawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
Hybrid Type

scholarly journals Lymph node status after resection of perihilar cholangiocarcinoma: Defining the optimal lymph node staging system

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e23
Author(s):  
F. Bagante ◽  
S.K. Maithel ◽  
G. Poultsides ◽  
R. Fields ◽  
S. Weber ◽  
...  
Keyword(s):  
Lymph Node ◽  
Staging System ◽  
Perihilar Cholangiocarcinoma ◽  
Lymph Node Status ◽  
Lymph Node Staging ◽  
Node Status

scholarly journals Comparison of the current AJCC-TNM numeric-based with a new anatomical location-based lymph node staging system for gastric cancer: A western experience

PLoS ONE ◽  
2017 ◽  
Vol 12 (4) ◽  
pp. e0173619 ◽  
Author(s):  
Gennaro Galizia ◽  
Eva Lieto ◽  
Annamaria Auricchio ◽  
Francesca Cardella ◽  
Andrea Mabilia ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
Anatomical Location ◽  
Western Experience
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