Prognosis of colorectal cancer patients is associated with the novel log odds of positive lymph nodes scheme: Derivation and external validation
Autor: | Yun-Jie Gao, Qing-Wei Zhang, Chi-Hao Zhang, Valeria Fico, Roberto Persiani, Xiao-Bo Li, Alberto Biondi, Yuan-Bo Pan, Hui-Min Chen, Zhi-Zheng Ge, Shan Wu, Ou-Min Shi |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Oncology
medicine.medical_specialty Multivariate statistics Colorectal cancer Settore MED/18 - CHIRURGIA GENERALE SEER Rectum 03 medical and health sciences 0302 clinical medicine Internal medicine Epidemiology Medicine Overall survival Stage (cooking) Multicenter Lymph node Log odds of positive lymph nodes business.industry Cause-specific survival medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis Cohort 030211 gastroenterology & hepatology Lymph business Research Paper |
Zdroj: | Journal of Cancer |
Popis: | Background and aim: To construct proper and externally validate cut-off points for log odds of positive lymph nodes scheme (LODDS) staging scheme in colorectal cancer (CRC). Patients and methods: The X-tile approach was used to find the cut-off points for the novel LODDS staging scheme in 240,898 patients from the Surveillance, Epidemiology and End Results (SEER) database and externally validated in 1,878 from the international multicenter cohort. Kaplan-Meier plot and multivariate Cox proportional hazard models were performed to investigate the role of the novel LODDS classification. Results: The prognostic cut-off values were determined as -2.18, and -0.23 (P< 0.001). Patients had 5-year cancer-specific survival rates of 83.8%, 57.4% and 24.4% with increasing LODDS (P< 0.001) in the SEER database. Five-year overall survival rates were 77.2%, 55.0% and 26.7% with increasing LODDS (P< 0.001) in the external international multicenter cohort. Multivariate survival analysis identified both the LODDS classification, the patient's age, the T category, the M status, and the tumor grade as independent prognostic factors in both two independent databases. The analyses of the subgroup of patients stratified by tumor location (colon or rectum), number of retrieved lymph node (< 12 or ≥ 12), TNM stage III, lymph node-negative also confirmed the LODDS as independent prognostic factors (P< 0.001) in both two independent databases. Conclusions: The novel LODDS classification was an independent prognostic factor for patients with CRCs and should be calculated for additional risk group stratification with pN scheme. |
Databáze: | OpenAIRE |
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