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Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer.

作者信息

Zheng Yangyang, Lu Zhenhua, Shi Xiaolei, Tan Tianhua, Xing Cheng, Xu Jingyong, Cui Hongyuan, Song Jinghai

机构信息

Department of General Surgery, Department of Hepato-bilio-pancreatic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Front Oncol. 2022 Sep 2;12:975846. doi: 10.3389/fonc.2022.975846. eCollection 2022.


DOI:10.3389/fonc.2022.975846
PMID:36119520
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9479329/
Abstract

BACKGROUND: The prognostic performance of four lymph node classifications, the 8th American Joint Committee on Cancer (AJCC) Tumor Node Metastasis (TNM) N stage, lymph node ratio (LNR), log odds of positive lymph nodes (LODDS), and examined lymph nodes (ELN) in early-onset pancreatic cancer (EOPC) remains unclear. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was searched for patients with EOPC from 2004 to 2016. 1048 patients were randomly divided into training (n = 733) and validation sets (n = 315). The predictive abilities of the four lymph node staging systems were compared using the Akaike information criteria (AIC), receiver operating characteristic area under the curve (AUC), and C-index. Multivariate Cox analysis was performed to identify independent risk factors. A nomogram based on lymph node classification with the strongest predictive ability was established. The nomogram's precision was verified by the C-index, calibration curves, and AUC. Kaplan-Meier analysis and log-rank tests were used to compare differences in survival at each stage of the nomogram. RESULTS: Compared with the 8th N stage, LODDS, and ELN, LNR had the highest C-index and AUC and the lowest AIC. Multivariate analysis showed that N stage, LODDS, LNR were independent risk factors associated with cancer specific survival (CSS), but not ELN. In the training set, the AUC values for the 1-, 3-, and 5-year CSS of the nomogram were 0.663, 0.728, and 0.760, respectively and similar results were observed in the validation set. In addition, Kaplan-Meier survival analysis showed that the nomogram was also an important factor in the risk stratification of EOPC. CONCLUSION: We analyzed the predictive power of the four lymph node staging systems and found that LNR had the strongest predictive ability. Furthermore, the novel nomogram prognostic staging mode based on LNR was also an important factor in the risk stratification of EOPC.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/070388a83188/fonc-12-975846-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/1ec98cf23205/fonc-12-975846-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/e5b65043d3a1/fonc-12-975846-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/40f8163c28b3/fonc-12-975846-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/cc8f95767f35/fonc-12-975846-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/070388a83188/fonc-12-975846-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/1ec98cf23205/fonc-12-975846-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/e5b65043d3a1/fonc-12-975846-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/40f8163c28b3/fonc-12-975846-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/cc8f95767f35/fonc-12-975846-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f3/9479329/070388a83188/fonc-12-975846-g005.jpg

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Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer.

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引用本文的文献

[1]
The Impact of Radioactive Iodine on Disease-Specific Survival in Low-to-Intermediate Risk N1b Papillary Thyroid Carcinoma.

Ann Surg Oncol. 2025-3

[2]
A 3 M Evaluation Protocol for Examining Lymph Nodes in Cancer Patients: Multi-Modal, Multi-Omics, Multi-Stage Approach.

Technol Cancer Res Treat. 2024

[3]
Naples Prognostic Score: A Novel Predictor of Survival in Patients with Triple-Negative Breast Cancer.

J Inflamm Res. 2024-8-8

[4]
Modified traditional TNM staging of pyriform sinus and hypopharyngeal and laryngeal cancer based on lymph node ratio and its clinical significance: a population-based study combined with external validation.

Int J Surg. 2025-1-1

[5]
Establishment and validation of a prognostic nomogram for postoperative patients with gastric cardia adenocarcinoma: A study based on the Surveillance, Epidemiology, and End Results database and a Chinese cohort.

Cancer Med. 2023-6

[6]
Analysis of risk factors of hepatocellular carcinoma and establishment of a clinical prognosis model.

Front Oncol. 2023-3-22

本文引用的文献

[1]
Prognostic value of lymph node involvement in oral squamous cell carcinoma.

Clin Oral Investig. 2022-11

[2]
Lymph Node Ratio Improves Prediction of Overall Survival in Esophageal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy: A National Cancer Database Analysis.

Ann Surg. 2023-6-1

[3]
Survival Nomogram for Young Breast Cancer Patients Based on the SEER Database and an External Validation Cohort.

Ann Surg Oncol. 2022-9

[4]
Early-onset pancreatic cancer: Clinical characteristics and survival outcomes.

Pancreatology. 2022-5

[5]
Trends in the Incidence and Treatment of Early-Onset Pancreatic Cancer.

Cancers (Basel). 2022-1-7

[6]
Cancer statistics, 2022.

CA Cancer J Clin. 2022-1

[7]
Prognostic Performance of Alternative Lymph Node Classification Systems for Patients with Medullary Thyroid Cancer: A Single Center Cohort Study.

Ann Surg Oncol. 2022-4

[8]
Predictive Performance of Current Nodal Staging Systems in Various Categories of Pancreatic Cancer.

Ann Surg Oncol. 2022-1

[9]
Long-Term Survivors after Upfront Resection for Pancreatic Ductal Adenocarcinoma: An Actual 5-Year Analysis of Disease-Specific and Post-Recurrence Survival.

Ann Surg Oncol. 2021-12

[10]
Treatment patterns and survival in patients with early-onset pancreatic cancer.

Cancer. 2021-10-1

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