Lee Jin Won, Ali Bandar, Park Cho Hyun, Song Kyo Young
Department of Surgery, Chuncheon Sacred Heart Hospital, The Hallym University of Korea, College of Medicine, Chuncheon Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Medicine (Baltimore). 2016 Jun;95(25):e3860. doi: 10.1097/MD.0000000000003860.
To investigate whether the log odds of positive lymph nodes (LODDS) system is a more accurate prognostic tool than the number-based (pN) or ratio-based (rN) lymph node staging system in Korean patients with gastric cancer (GC).The LODDS is a recently proposed staging modality in surgical oncology. However, it is unclear whether LODDS is superior to the pN or rN system in terms of predicting the prognosis of GC patients who underwent radical gastrectomy with extended lymphadenectomy and had a greater number of retrieved lymph nodes.Clinicopathological data from 3929 patients who had undergone curative gastrectomy for GC were reviewed. In addition, overall survival rates according to pN and rN classification stratified by the LODDS were analyzed. A multivariate analysis of survival rate was performed using a Cox proportional hazard model.pN, rN, and LODDS were significantly correlated with 5-year survival rate. Spearman correlation test showed no correlation between LODDS and number of lymph nodes retrieved. The receiver operating characteristic (ROC) curves showed that the 3 staging systems had comparable prognostic accuracy (P < 0.05). Survival analysis according to pN and rN classification stratified by the LODDS staging system demonstrated that LODDS is superior to pN and rN.The LODDS is independently and significantly associated with the OS of Korean patients with GC, and its prognostic value is superior to that of the other lymph node staging systems in Korean patients.
目的在于探究在韩国胃癌（GC）患者中，阳性淋巴结对数比值（LODDS）系统相较于基于数量（pN）或基于比值（rN）的淋巴结分期系统而言，是否是一种更准确的预后评估工具。LODDS是外科肿瘤学中最近提出的一种分期方式。然而，对于接受根治性胃切除术及扩大淋巴结清扫术且获取淋巴结数量较多的GC患者，在预测其预后方面，LODDS是否优于pN或rN系统尚不清楚。回顾了3929例接受GC根治性胃切除术患者的临床病理资料。此外，还分析了根据LODDS分层的pN和rN分类的总生存率。使用Cox比例风险模型对生存率进行多因素分析。pN、rN和LODDS与5年生存率显著相关。Spearman相关性检验显示LODDS与获取的淋巴结数量之间无相关性。受试者工作特征（ROC）曲线显示，这三种分期系统具有相当的预后准确性（P<0.05）。根据LODDS分期系统分层的pN和rN分类进行的生存分析表明，LODDS优于pN和rN。LODDS与韩国GC患者的总生存期独立且显著相关，并且在韩国患者中，其预后价值优于其他淋巴结分期系统。
