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Prognostic Performance of Three Lymph-Node Staging Systems on Gastric Signet-Ring-Cell Carcinoma.

Limin Zhang¹, Yan Ma¹, Bao Liu²

¹Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, China.

|June 28, 2023

Summary

The log odds of positive lymph nodes (LODDS) system offers superior prognostic prediction for both early and advanced gastric signet-ring-cell carcinoma (SRCC) compared to traditional pN staging and lymph-node metastasis rate (LNR). This finding aids in better patient outcome assessment for SRCC.

Keywords:

LODDS gastric signet cell carcinoma lymph-node metastases prognosis

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Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT

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Published on: January 22, 2018

Area of Science:

Oncology
Gastroenterology
Surgical Pathology

Background:

Lymph-node staging is crucial for predicting gastric signet-ring-cell carcinoma (SRCC) prognosis.
Existing staging systems show disparities between early and advanced SRCC.
The optimal lymph-node staging system for SRCC remains undetermined.

Purpose of the Study:

To compare the prognostic predictive performance of three lymph-node staging systems: pN staging, lymph-node metastasis rate (LNR), and log odds of positive lymph nodes (LODDS).
To evaluate the effectiveness of these systems in both early and advanced SRCC.
To identify the most accurate system for predicting patient outcomes in SRCC.

Main Methods:

Retrospective analysis of 693 SRCC patients who underwent radical resection.
Comparison of pN staging, LNR, and LODDS using receiver operating characteristic (ROC) curves and c-index.
Survival analysis using Kaplan-Meier method and log-rank test.
Identification of independent risk factors via Cox regression analysis.
Development of a prognostic nomogram using R studio.

Main Results:

Log odds of positive lymph nodes (LODDS) demonstrated superior predictive performance over pN staging and LNR in both early and advanced SRCC.
LODDS was identified as an independent risk factor for patient outcomes in SRCC (p = 0.002, p < 0.001).
A nomogram incorporating LODDS and clinicopathological features exhibited strong predictive accuracy.

Conclusions:

LODDS offers significant prognostic superiority compared to pN staging and LNR for both early and advanced gastric signet-ring-cell carcinoma.
The LODDS system provides a more reliable tool for assessing SRCC prognosis.
The developed nomogram can aid in clinical decision-making and patient management.