Log odds of positive lymph nodes is a better prognostic factor for oesophageal signet ring cell carcinoma than N stage
| Autor: | Xiang-Yang Yu, Yin Li, Feng Wang, Jun Zhao, Yousheng Mao, Hong Cheng, Fengwei Tan, Chen-Guang Zhao, Juwei Mu, Dali Wang, Shugeng Gao, Yushun Gao, Qi Xue |
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| Rok vydání: | 2020 |
| Předmět: |
Prognostic factor
medicine.medical_specialty Log odds Signet ring cell Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Signet ring cell carcinoma mental disorders Medicine Retrospective Cohort Study Lymph nodes Log odds of positive lymph nodes TNM stage business.industry General Medicine medicine.disease Prognosis digestive system diseases Oesophageal neoplasms 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Lymph business |
| Zdroj: | World Journal of Clinical Cases |
| ISSN: | 2307-8960 |
| Popis: | BACKGROUND Signet ring cell carcinoma is a rare type of oesophageal cancer, and we hypothesized that log odds of positive lymph nodes (LODDS) is a better prognostic factor for oesophageal signet ring cell carcinoma. AIM To explore a novel prognostic factor for oesophageal signet ring cell carcinoma by comparing two lymph node-related prognostic factors, log odds of positive LODDS and N stage. METHODS A total of 259 cases of oesophageal signet ring cell carcinoma after oesopha-gectomy were obtained from the Surveillance, Epidemiology, and End Results database between 2006 and 2016. The prognostic value of LODDS and N stage for oesophageal signet ring cell carcinoma was evaluated by univariate and multivariate analyses. The Akaike information criterion and Harrell’s C-index were used to assess the value of two prediction models based on lymph nodes. External validation was performed to further confirm the conclusion. RESULTS The 5-year cancer-specific survival (CSS) and 5-year overall survival (OS) rates of all the cases were 41.3% and 27.0%, respectively. The Kaplan-Meier method showed that LODDS had a higher score of log rank chi-squared (OS: 46.162, CSS: 41.178) than N stage (OS: 36.215, CSS: 31.583). Univariate analyses showed that insurance, race, T stage, M stage, TNM stage, radiation therapy, N stage, and LODDS were potential prognostic factors for OS (P < 0.1). The multivariate Cox regression model showed that LODDS was an significant independent prognostic factor for oesophageal signet ring carcinoma patients after surgical resection (P < 0.05), while N stage was not considered to be a significant prognostic factor (P = 0.122). Model 2 (LODDS) had a higher degree of discrimination and fit than Model 1 (N stage) (LODDS vs N stage, Harell’s C-index 0.673 vs 0.656, P < 0.001; Akaike information criterion 1688.824 vs 1697.519, P < 0.001). The results of external validation were consistent with those in the study cohort. CONCLUSION LODDS is a superior prognostic factor to N stage for patients with oesophageal signet ring cell carcinoma after oesophagectomy. |
| Databáze: | OpenAIRE |
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