Xiao Zunqiang, Shi Zhan, Hu Linjun, Gao Yuling, Zhao Junjun, Liu Yang, Xu Qiuran, Huang Dongsheng
The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310014, China.
The Medical College of Qingdao University, Qingdao 266071, China.
Ann Transl Med. 2019 Dec;7(23):738. doi: 10.21037/atm.2019.11.112.
BACKGROUND: To study the prognostic significance in gallbladder cancer (GBC) patients of the four N stage methods of log odds of positive lymph nodes (LODDS), lymph node ratio (LNR), and N stage in the 7th and 8 editions of the American Joint Committee on Cancer (AJCC), and to establish a prognostic model of GBC based on LODDS. METHODS: Data of 1,321 patients with GBC who underwent surgical resection of lymph nodes from 2010 to 2014 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. We then randomly divided these data into a training set (n=925) and a validation set (n=396). C-index, Akaike information criterion (AIC), and area under the curve (AUC) were calculated to evaluate the accuracy of LODDS, LNR, and N stage in the 7 and 8 editions of the AJCC. Cox multivariate analysis was performed to determine whether LODDS was an independent prognostic factor, and a nomogram model was established. C-index was used to evaluate the accuracy of the nomogram. A receiver operating characteristic (ROC) curve was drawn and the area under the AUC was calculated to evaluate the accuracy of the nomogram in predicting patients' 1-, 3-, and 5-year overall survival (OS). RESULTS: Univariate analysis showed that the four methods were all correlated with OS. Through C-index, AIC and AUC, We found that LODDS had the best accuracy of the four methods. C-index and AUC analysis revealed that the nomogram based on LODDS had excellent prognostic ability. All the results were verified in the validation set. CONCLUSIONS: LODDS is an independent prognostic factor for GBC patients, and it is the best N stage in the SEER database. This new nomogram-containing LODDS system is a great model to predict the prognosis of GBC patients.
背景:研究美国癌症联合委员会(AJCC)第7版和第8版中阳性淋巴结对数比(LODDS)、淋巴结比率(LNR)以及N分期这四种N分期方法对胆囊癌(GBC)患者的预后意义,并基于LODDS建立GBC的预后模型。 方法:收集2010年至2014年接受淋巴结手术切除的1321例GBC患者的数据,数据来自监测、流行病学和最终结果(SEER)数据库。然后将这些数据随机分为训练集(n = 925)和验证集(n = 396)。计算C指数、赤池信息准则(AIC)和曲线下面积(AUC),以评估AJCC第7版和第8版中LODDS、LNR和N分期的准确性。进行Cox多因素分析以确定LODDS是否为独立预后因素,并建立列线图模型。使用C指数评估列线图的准确性。绘制受试者工作特征(ROC)曲线并计算AUC,以评估列线图预测患者1年、3年和5年总生存(OS)的准确性。 结果:单因素分析显示这四种方法均与OS相关。通过C指数、AIC和AUC,我们发现LODDS在这四种方法中准确性最佳。C指数和AUC分析显示基于LODDS的列线图具有出色的预后能力。所有结果在验证集中均得到验证。 结论:LODDS是GBC患者的独立预后因素,且是SEER数据库中最佳的N分期。这个包含LODDS的新列线图系统是预测GBC患者预后的优秀模型。
World J Clin Cases. 2021-7-26
World J Gastrointest Surg. 2023-11-27
J Cancer Res Clin Oncol. 2024-10-6
Korean J Hepatobiliary Pancreat Surg. 2015-2