Shengming Jin1,2, Junjie Wang1,2, Yijun Shen1,2, Hualei Gan2,3, Peihang Xu1,2, Yu Wei1,2, Jiaming Wei1,2, Junlong Wu1,2, Beihe Wang1,2, Jun Wang1,2, Chen Yang4, Yao Zhu5,6, Dingwei Ye7,8. 1. Department of Urology, Fudan University Shanghai Cancer Center, No.270 at Dong'an Road, Xuhui District, Shanghai, 200032, People's Republic of China. 2. Department of Oncology, Shanghai Medical College, Fudan University, No.130 at Dong'an Road, Xuhui District, Shanghai, 200032, People's Republic of China. 3. Department of Pathology, Fudan University Shanghai Cancer Center, No.270 at Dong'an Road, Xuhui District, Shanghai, 200032, People's Republic of China. 4. Department of Urology, Huashan Hospital, Fudan University, No.12 at Middle Wulumuqi Road, Jing'an District, Shanghai, 200040, People's Republic of China. 5. Department of Urology, Fudan University Shanghai Cancer Center, No.270 at Dong'an Road, Xuhui District, Shanghai, 200032, People's Republic of China. mailzhuyao@163.com. 6. Department of Oncology, Shanghai Medical College, Fudan University, No.130 at Dong'an Road, Xuhui District, Shanghai, 200032, People's Republic of China. mailzhuyao@163.com. 7. Department of Urology, Fudan University Shanghai Cancer Center, No.270 at Dong'an Road, Xuhui District, Shanghai, 200032, People's Republic of China. dwyeuro@163.com. 8. Department of Oncology, Shanghai Medical College, Fudan University, No.130 at Dong'an Road, Xuhui District, Shanghai, 200032, People's Republic of China. dwyeuro@163.com.
Abstract
PURPOSE: In addition to standard TNM N staging, lymph node ratio (LNR) and log odds of metastatic lymph node (LODDS) staging methods have been developed for cancer staging. We compared the prognostic performance of the total number of lymph nodes examined (TNLE), number of metastatic lymph node (NMLN), LNR, and LODDS in prostate cancer. METHODS: Data from 1400 patients diagnosed with prostate cancer between 2004 and 2009 who underwent lymphadenectomy were extracted from the Surveillance Epidemiology and End Results database. Kaplan-Meier methods and multivariable Cox regression analysis were used to evaluate the prognostic value of different lymph node staging schemes in patients with lymph node metastasis. RESULTS: Univariate analysis showed that age, T stage, radiotherapy history, Gleason score, LNR classification, LODDS classification, and NMLN except TNLE classification were significant prognostic factors for overall survival. In multivariate analysis, LNR classification, LODDS classification, and NMLN but TNLE classification remained significant prognostic factors for overall survival. LNR classification had the highest C-index (0.672; 95% confidence interval [CI]: 0.609-0.734) and the lowest Akaike information criterion (AIC) (4057.018), indicating the best prognostic performance. Scatter plots showed that LODDS increased with increasing LNR, exhibiting a strong overall correlation between these two lymph node staging methods (r2 = 0.9072). LNR and LODDS generally increased with increasing NMLN, although the correlation was relatively low. CONCLUSION: Our results indicate that LNR and LODDS may be better predictors of overall survival than the AJCC/UICC N category in patients undergoing curative surgery for prostate cancer.
PURPOSE: In addition to standard TNM N staging, lymph node ratio (LNR) and log odds of metastatic lymph node (LODDS) staging methods have been developed for cancer staging. We compared the prognostic performance of the total number of lymph nodes examined (TNLE), number of metastatic lymph node (NMLN), LNR, and LODDS in prostate cancer. METHODS: Data from 1400 patients diagnosed with prostate cancer between 2004 and 2009 who underwent lymphadenectomy were extracted from the Surveillance Epidemiology and End Results database. Kaplan-Meier methods and multivariable Cox regression analysis were used to evaluate the prognostic value of different lymph node staging schemes in patients with lymph node metastasis. RESULTS: Univariate analysis showed that age, T stage, radiotherapy history, Gleason score, LNR classification, LODDS classification, and NMLN except TNLE classification were significant prognostic factors for overall survival. In multivariate analysis, LNR classification, LODDS classification, and NMLN but TNLE classification remained significant prognostic factors for overall survival. LNR classification had the highest C-index (0.672; 95% confidence interval [CI]: 0.609-0.734) and the lowest Akaike information criterion (AIC) (4057.018), indicating the best prognostic performance. Scatter plots showed that LODDS increased with increasing LNR, exhibiting a strong overall correlation between these two lymph node staging methods (r2 = 0.9072). LNR and LODDS generally increased with increasing NMLN, although the correlation was relatively low. CONCLUSION: Our results indicate that LNR and LODDS may be better predictors of overall survival than the AJCC/UICC N category in patients undergoing curative surgery for prostate cancer.
Authors: Gaya Spolverato; Aslam Ejaz; Yuhree Kim; Malcolm H Squires; George Poultsides; Ryan C Fields; Mark Bloomston; Sharon M Weber; Konstantinos Votanopoulos; Alexandra W Acher; Linda X Jin; William G Hawkins; Carl Schmidt; David A Kooby; David Worhunsky; Neil Saunders; Clifford S Cho; Edward A Levine; Shishir K Maithel; Timothy M Pawlik Journal: Ann Surg Date: 2015-12 Impact factor: 12.969
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