Dataset Information

Development and validation of a novel staging system integrating the number and location of lymph nodes for gastric adenocarcinoma.

ABSTRACT:

Background

Evidence suggests that the anatomic extent of metastatic lymph nodes (MLNs) affects prognosis, as proposed by alternative staging systems. The aim of this study was to establish a new staging system based on the number of perigastric (PMLN) and extra-perigastric (EMLN) MLNs.

Methods

Data from a Chinese cohort of 1090 patients who had undergone curative gastrectomy with D2 or D2 plus lymphadenectomy for gastric cancer were retrospectively analysed. A Japanese validation cohort (n?=?826) was included. Based on the Cox proportional hazards model, the regression coefficients of PMLN and EMLN were used to calculate modified MLN (MMLN). Prognostic performance of the staging systems was evaluated.

Results

PMLN and EMLN were independent prognostic factors in multivariate analysis (coefficients: 0.044, 0.115; all P?20).

Discussion

The MMLN staging system is suitable for assessing overall survival among patients undergoing curative gastrectomy with D2 or D2 plus lymphadenectomy.

SUBMITTER: Li Z

PROVIDER: S-EPMC7921685 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Development and validation of a novel staging system integrating the number and location of lymph nodes for gastric adenocarcinoma.

Li Ziyu Z Wu Xiaolong X Gao Xiangyu X Shan Fei F Ying Xiangji X Zhang Yan Y Ji Jiafu J

British journal of cancer 20201202 5

<h4>Background</h4>Evidence suggests that the anatomic extent of metastatic lymph nodes (MLNs) affects prognosis, as proposed by alternative staging systems. The aim of this study was to establish a new staging system based on the number of perigastric (PMLN) and extra-perigastric (EMLN) MLNs.<h4>Methods</h4>Data from a Chinese cohort of 1090 patients who had undergone curative gastrectomy with D2 or D2 plus lymphadenectomy for gastric cancer were retrospectively analysed. A Japanese validation ...[more]

PMID: 33262519

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Project description:It is important to identify superficial (T1) gastroesophageal adenocarcinomas (EAC) that are most or least likely to metastasize to lymph nodes, to select appropriate therapy. We aimed to develop a risk stratification model for metastasis of superficial EAC to lymph nodes using pathologic features of the primary tumor.We collected pathology data from 210 patients with T1 EAC who underwent esophagectomy from 1996 through 2012 on factors associated with metastasis to lymph nodes (tumor size, grade, angiolymphatic invasion, and submucosal invasion). Using these variables, we developed a multivariable logistic model to generate 4 categories for estimated risk of metastasis (<5% risk, 5%-10% risk, 15%-20% risk, or >20% risk). The model was validated in a separate cohort of 39 patients who underwent endoscopic resection of superficial EAC and subsequent esophagectomy, with node stage analysis.We developed a model based on 4 pathologic factors that determined risk of metastasis to range from 2.9% to 60% for patients in the first cohort. In the endoscopic resection validation cohort, higher risk scores were associated with increased detection of lymph node metastases at esophagectomy (P = .021). Among patients in the first cohort who did not have lymph node metastases detected before surgery (cN0), those with high risk scores (>20% risk) had 11-fold greater odds for having lymph node metastases at esophagectomy compared with patients with low risk scores (95% confidence interval, 2.3-52 fold). Increasing risk scores were associated with reduced patient survival time (P < .001) and shorter time to tumor recurrence (P < .001). Patients without lymph node metastases (pT1N0) but high risk scores had reduced times of survival (P < .001) and time to tumor recurrence (P = .001) after esophagectomy than patients with pT1N0 tumors and lower risk scores.Pathologic features of primary superficial EACs can be used, along with the conventional node staging system, to identify patients at low risk for metastasis, who can undergo endoscopic resection, or at high risk, who may benefit from induction or adjuvant therapy.

Dataset Information

Development and validation of a novel staging system integrating the number and location of lymph nodes for gastric adenocarcinoma.

Background

Methods

Results

Discussion

Publications

Development and validation of a novel staging system integrating the number and location of lymph nodes for gastric adenocarcinoma.

Similar Datasets

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