Dataset Information

Log odds of positive lymph nodes as a novel prognostic predictor for gastric cancer: a systematic review and meta-analysis.

ABSTRACT:

Background

We conducted a systematic review and meta-analysis to summarize the predictive and prognostic ability of the log odds of positive lymph nodes (LODDS) staging system and compare it with pathological N (pN) classification and the ratio-based lymph node system (rN) for the overall survival (OS) of gastric cancer (GC).

Methods

Through a systematic review till March 7, 2022, we identified population-based studies that reported the prognostic effects of LODDS in patients with GC. We compare the predictive effectiveness of the LODDS staging system with that of the rN and pN classification systems for the OS of GC.

Results

Twelve studies comprising 20,312 patients were included in this systematic review and meta-analysis. The results showed that LODDS1, LODDS2, LODDS3, and LODDS4 in GC patients were correlated with poor OS compared with LODDS0 (LODDS1 vs. LODDS0: HR = 1.62, 95% CI (1.42, 1.85); LODDS2 vs. LODDS0: HR = 2.47, 95% CI (2.02, 3.03); LODDS3 vs. LODDS0: HR = 3.15, 95% CI (2.50, 3.97); LODDS4 vs. LODDS0: HR = 4.55, 95% CI (3.29, 6.29)). Additionally, significant differences in survival were observed among patients with different LODDS classifications (all P-values were < 0.001) with the same rN and pN classifications. Meanwhile, for patients with different pN or rN classifications with the same LODDS classification, prognosis was highly similar.

Conclusion

The findings show that LODDS is correlated with the prognosis of GC patients and is superior to the pN and rN classifications for prognostic assessment.

SUBMITTER: Li Y

PROVIDER: S-EPMC10251690 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

Log odds of positive lymph nodes as a novel prognostic predictor for gastric cancer: a systematic review and meta-analysis.

Li Yiding Y Wu Guiling G Liu Jinqiang J Zhang Yujie Y Yang Wanli W Wang Xiaoqian X Duan Lili L Niu Liaoran L Chen Junfeng J Zhou Wei W Han Weili W Wang Jing J Zhong Helun H Ji Gang G Fan Daiming D Hong Liu L

BMC cancer 20230608 1

<h4>Background</h4>We conducted a systematic review and meta-analysis to summarize the predictive and prognostic ability of the log odds of positive lymph nodes (LODDS) staging system and compare it with pathological N (pN) classification and the ratio-based lymph node system (rN) for the overall survival (OS) of gastric cancer (GC).<h4>Methods</h4>Through a systematic review till March 7, 2022, we identified population-based studies that reported the prognostic effects of LODDS in patients with ...[more]

PMID: 37291493

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Project description:BackgroundNeoadjuvant chemoradiotherapy (NCRT) results in fewer lymph nodes harvested and causes staging migration. Therefore, we compared the prognostic value of the logarithmic odds of positive lymph nodes (LODDS) with the lymph node ratio (LNR) and the American Joint Committee on Cancer (AJCC) ypN stage in patients with locally advanced rectal cancer (LARC) after NCRT.MethodsA total of 445 patients with LARC who received NCRT and underwent radical surgery between January 2004 and December 2015 were recruited, and data from 4881 patients included in the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2013 were analyzed to verify our results. The time-dependent area under the receiver operating characteristic curve (TimeROC) was used to evaluate the discriminative ability of the different lymph node staging systems.ResultsypN staging failed to satisfactorily stratify the patients treated with NCRT [the 3-year disease-free survival (DFS) rates were 65.7% and 55.4% for the ypN1 and ypN2 groups, respectively, P=0.252]. The LODDS classification was significantly associated with DFS, and the 3-year DFS rates for the LODDS0, LODDS1, and LODDS2 groups were 89.9%, 72.4%, and 53.9%, respectively (P<0.05 across all groups). Furthermore, the LODDS classification system was able to subclassify patients with ypN0 stage tumors regardless of whether ≥12 or <12 total lymph nodes (TLNs) were harvested. TimeROC analysis showed that the LODDS classification (AUC, median: 0.722, range: 0.692-0.754) had a higher accuracy for determining the prognosis than the ypN stage (AUC, median: 0.691, range: 0.684-0.712) or the LNR (AUC, median: 0.703, range: 0.685-0.730) classification, regardless of lymph node status. These results were verified using the SEER database.ConclusionsThe LODDS was a better prognostic factor for DFS than ypN staging or the LNR-based approach in patients with LARC after NCRT, particularly those with <12 TLNs harvested or ypN0 stage disease.

Project description:BACKGROUND:Globally, colorectal cancer (CRC) is the third and second leading cancer in men and women respectively with 600,000 deaths per year. Traditionally, clinicians have relied solely on nodal disease involvement, and measurements such as lymph node ratio (LNR; the ratio of metastatic/positive lymph nodes to total number of lymph nodes examined), when determining patient prognosis in CRC. The log odds of positive lymph nodes (LODDS) is a logistic transformation formula that uses pathologic lymph node data to stratify survival differences among patients within a single stage of disease. This formula allows clinicians to identify whether patients with clinically aggressive tumours fall into higher-risk groups regardless of nodal positivity and can potentially guide adjuvant treatment modalities. The aim of this study was to investigate whether LODDS in colon cancer provides better prognostication compared to LNR. METHODS:A retrospective study of patients on the prospectively maintained Cabrini Monash University Department of Surgery colorectal neoplasia database, incorporating data from hospitals in Melbourne Australia, identified patients entered between January 2010 and March 2016. Association of LODDS and LNR with clinical variables were analysed. Disease-free (DFS) and overall (OS) survival were investigated with Cox regression and Kaplan-Meier survival analyses. RESULTS:There were 862 treatment episodes identified in the database (402 male, 47%). The median patient age was 73 (range 22-100?years). There were 799 colonic cancers and 63 rectosigmoid cancers. The lymph node yield (LNY) was suboptimal (<?12) in 168 patients (19.5%) (p?=?0.05). The 5-year OS for the different LNR groups were 86, 91 and 61% (p?<?0.001) for LNR0 (655 episodes), LNR1 (128 episodes) and LNR2 (78 episodes), respectively. For LODDS, they were 85, 91 and 61% (p?<?0.001) in LODDS0 (569 episodes), LODDS1 (217 episodes) and LODDS2 (75 episodes) groups (p?<?0.001). Overall survival rates were comparable between the LNR and LODDS group and for LNY?<?12 and stage III patients when each were sub-grouped by LODDS and LNR. CONCLUSION:This study has shown for that the prognostic impact of LODDS is comparable to LNR for colon cancer patients. Accordingly, LNR is recommended for prognostication given its ease of calculation.

Project description:BackgroundLog odds of positive lymph nodes (LODDS) is a novel and promising ratio-based lymph node (LN) staging system in many malignancies. This study aimed to evaluate the prognostic value of LODDS, and comprehensively compare the prognostic predictive performance of LODDS with the American Joint Committee on Cancer (AJCC) N classification, number of positive lymph node (NPLN), and lymph node ratio (LNR) among node-positive lung squamous cell carcinoma (SCC) patients after surgery.MethodsWe identified 2,561 patients with N1/N2 stage SCC diagnosed between 2004 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) database. X-tile analysis was used to calculate the optimal cut-off value for each staging system. Univariable and Multivariable Cox regression analyses were used to assess the association of cancer-specific survival (CSS), and overall survival (OS) with N, NPLN, LNR, and LODDS, separately, and integrally. Moreover, linear trend χ2 score, likelihood ratio (LR) test, Akaike information criterion (AIC), and Harrell concordance index (C-index) were adopted as criteria for assessing the predictive ability of each model.ResultsThe optimal cut-off values for NPLN, LNR, and LODDS were 3, 0.28, and -0.37, respectively. N, NPLN, LNR, and LODDS were identified as independent prognostic predictors for CSS and OS in patients with SCC when each of them was incorporated into multivariable Cox model separately. Additionally, LODDS had the higher linear trend χ2 score, higher LR χ2 test score, lower AIC, and higher C-index compared to the other three systems. Moreover, a combination of N, NPLN, and LODDS was superior to any staging system alone for predicting prognosis.ConclusionsLODDS showed better predictive performance than N, NPLN, and LNR among patients with node-positive SCC after surgery. A combination of LODDS and the current AJCC TNM classification has the potential for becoming a better staging method to more precisely predicting prognosis.

Dataset Information

Log odds of positive lymph nodes as a novel prognostic predictor for gastric cancer: a systematic review and meta-analysis.

Background

Methods

Results

Conclusion

Publications

Log odds of positive lymph nodes as a novel prognostic predictor for gastric cancer: a systematic review and meta-analysis.

Similar Datasets

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