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基于阳性淋巴结对数优势比的预后模型预测直肠癌患者的预后。

A Prognostic Model Based on the Log Odds Ratio of Positive Lymph Nodes Predicts Prognosis of Patients with Rectal Cancer.

机构信息

Department of General Surgery, General Hospital of Northern Theater Command (Teaching Hospital of China Medical University), Shenyang, China.

Jinzhou Medical University, Jinzhou, China.

出版信息

J Gastrointest Cancer. 2024 Sep;55(3):1111-1124. doi: 10.1007/s12029-024-01046-2. Epub 2024 May 3.


DOI:10.1007/s12029-024-01046-2
PMID:38700666
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11347484/
Abstract

OBJECTIVE: This study aimed to compare the prognostic value of rectal cancer by comparing different lymph node staging systems, and a nomogram was constructed based on superior lymph node staging. METHODS: Overall, 8700 patients with rectal cancer was obtained from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. The area under the curve (AUC), the C index, and the Akaike informativeness criteria (AIC) were used to examine the predict ability of various lymph node staging methods. Prognostic indicators were assessed using univariate and multivariate COX regression, and further correlation nomograms were created after the data were randomly split into training and validation cohorts. To evaluate the effectiveness of the model, the C index, calibration curves, decision curves (DCA), and receiver operating characteristic curve (ROC) were used. We ran Kaplan-Meier survival analyses to look for variations in risk classification. RESULTS: While compared to the N-stage positive lymph node ratio (LNR), the log odds ratio of positive lymph nodes (LODDS) had the highest predictive effectiveness. Multifactorial COX regression analyses were used to create nomograms for overall survival (OS) and cancer-specific survival (CSS). The C indices of OS and CSS for this model were considerably higher than those for TNM staging in the training cohort. The created nomograms demonstrated good efficacy based on ROC, rectification, and decision curves. Kaplan-Meier survival analysis revealed notable variations in patient survival across various patient strata. CONCLUSIONS: Compared to AJCC staging, the LODDS-based nomograms have a more accurate predictive effectiveness in predicting OS and CSS in patients with rectal cancer.

摘要

目的:本研究旨在通过比较不同的淋巴结分期系统来比较直肠癌的预后价值,并构建基于优势淋巴结分期的列线图。

方法:本研究从 2010 年至 2015 年的监测、流行病学和最终结果(SEER)数据库中获得了 8700 例直肠癌患者的数据。使用曲线下面积(AUC)、C 指数和 Akaike 信息量标准(AIC)来评估各种淋巴结分期方法的预测能力。使用单因素和多因素 COX 回归评估预后指标,并在将数据随机分为训练和验证队列后进一步构建相关联的列线图。为了评估模型的有效性,使用 C 指数、校准曲线、决策曲线(DCA)和接收器操作特征曲线(ROC)进行评估。我们进行了 Kaplan-Meier 生存分析,以寻找风险分类的变化。

结果:与 N 分期阳性淋巴结比例(LNR)相比,阳性淋巴结的对数优势比(LODDS)具有最高的预测效果。使用多因素 COX 回归分析为总生存(OS)和癌症特异性生存(CSS)创建了列线图。该模型在训练队列中的 OS 和 CSS 的 C 指数明显高于 TNM 分期。基于 ROC、校正和决策曲线,所创建的列线图显示出良好的效果。Kaplan-Meier 生存分析显示,不同患者分层的患者生存存在显著差异。

结论:与 AJCC 分期相比,基于 LODDS 的列线图在预测直肠癌患者的 OS 和 CSS 方面具有更高的预测准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/779ef803bcc3/12029_2024_1046_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/45480aaa13be/12029_2024_1046_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/0efec071c300/12029_2024_1046_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/a65b05f3e8d1/12029_2024_1046_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/d21f38d5d086/12029_2024_1046_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/af99f9c4bfe7/12029_2024_1046_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/4179aca959c8/12029_2024_1046_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/ba2d445588d9/12029_2024_1046_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/302ff78279c6/12029_2024_1046_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/779ef803bcc3/12029_2024_1046_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/45480aaa13be/12029_2024_1046_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/0efec071c300/12029_2024_1046_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/a65b05f3e8d1/12029_2024_1046_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/d21f38d5d086/12029_2024_1046_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/af99f9c4bfe7/12029_2024_1046_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/4179aca959c8/12029_2024_1046_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/ba2d445588d9/12029_2024_1046_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/302ff78279c6/12029_2024_1046_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adc/11347484/779ef803bcc3/12029_2024_1046_Fig9_HTML.jpg

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引用本文的文献

[1]
Comparison of LNR- and LODDS-based predictive models for prognosis in non-elderly patients with locally advanced rectal cancer undergoing neoadjuvant therapy.

Int J Colorectal Dis. 2025-7-12

[2]
Lymph node ratio emerges as a pivotal prognostic determinant for cancer-specific survival amidst individuals diagnosed with stage N1 and N2 non-small cell lung carcinoma: A population-based retrospective cohort study.

Medicine (Baltimore). 2025-4-18

本文引用的文献

[1]
Log odds of positive lymph nodes show better predictive performance on the prognosis of early-onset colorectal cancer.

Int J Colorectal Dis. 2023-7-11

[2]
A nomogram based on the log odds of positive lymph nodes for predicting the prognosis of T1 stage rectal cancer.

Am J Cancer Res. 2023-4-15

[3]
Development and validation of nomograms for predicting overall survival and cancer-specific survival in elderly patients with locally advanced gastric cancer: a population-based study.

BMC Gastroenterol. 2023-4-11

[4]
Differences in prognosis and underuse of adjuvant chemotherapy between elderly and non-elderly patients in stage III colorectal cancer.

Ann Gastroenterol Surg. 2022-8-26

[5]
Prognostic nomogram based on the lymph node metastasis indicators for patients with bladder cancer: A SEER population-based study and external validation.

Cancer Med. 2023-3

[6]
Rectal Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology.

J Natl Compr Canc Netw. 2022-10

[7]
Development and Validation of a New Lymph Node Ratio-Based Staging System for Ampullary Carcinoma After Curative Pancreaticoduodenectomy.

Front Oncol. 2022-1-20

[8]
Predictive and Prognostic Effects of Primary Tumor Size on Colorectal Cancer Survival.

Front Oncol. 2021-12-9

[9]
Age Determines Adjuvant Chemotherapy Use in Resected Stage II Colon Cancer.

Dis Colon Rectum. 2022-10-1

[10]
Magnetic Resonance Imaging Evaluation of the Accuracy of Various Lymph Node Staging Criteria in Rectal Cancer: A Systematic Review and Meta-Analysis.

Front Oncol. 2021-7-13

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