ArticleAnnals of surgery2023
Lymph Node Ratio Improves Prediction of Overall Survival in Esophageal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy: A National Cancer Database Analysis.
Article in Annals of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06490003 (Predicting Postoperative Chemotherapy Efficacy in Patients With Esophageal Squamous Cell Carcinoma by Biopsy Specimens.), which is not on this map. Cited by 29 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Predicting Postoperative Chemotherapy Efficacy in Patients With Esophageal Squamous Cell Carcinoma by Biopsy Specimens.
Who cites it
29 citing papers in PubMed.
- Log Odds of Positive Lymph Nodes Improves Risk Stratification for Early Recurrence and Survival After Radical Esophagectomy for cT3 Esophageal Squamous Cell Carcinoma.Annals of surgical oncology · 2026Article
- Nodal Zone Count Versus ypN Stage for Predicting First Distant Metastasis After Neoadjuvant Therapy and Esophagectomy in Esophageal Squamous Cell Carcinoma.Annals of surgical oncology · 2026Article
- SurvGRN: a multi-feature fusion framework for bladder cancer survival prediction.International journal of surgery (London, England) · 2026Article
- Prognostic Significance of Lymph Node Ratio for Overall Survival in Patients with Lymph Node-Positive Bladder Cancer Post-Radical Cystectomy and Chemotherapy: A Multicenter Cohort Analysis.Annals of surgical oncology · 2026Article
- No incremental discriminative value of hemoglobin beyond GNRI for predicting mortality in older adult with sepsis.BMC geriatrics · 2026Article
- Development of a prognostic model based on positive lymph node ratio for yp stage III colorectal cancer.Updates in surgery · 2026Article
- Validation and refinement of the AJCC 8th edition ypStage in esophageal squamous cell carcinoma after neoadjuvant therapy: a large-scale retrospective cohort study.International journal of surgery (London, England) · 2026Article
- Refining post-neoadjuvant risk stratification in ESCC with lymph node regression grade.Frontiers in oncology · 2026Article
- Number of Examined Lymph Nodes in the Highest Quartile Enhances Staging and Prognosis for Patients with Esophageal Cancer Receiving Neoadjuvant Therapy.Annals of surgical oncology · 2026Article
- Development of a predictive model for lymph node metastasis in esophageal cancer usingJournal of gastrointestinal oncology · 2025Article
- Influential factors affecting the survival benefit of combined neoadjuvant therapy and esophagectomy in patients with esophageal cancer: an analysis based on the SEER database.Translational cancer research · 2025Article
- Development and validation of a prognostic model for overall survival in pN0 esophageal cancer patients after neoadjuvant chemotherapy: a SEER database-based study.Journal of thoracic disease · 2025Article
- Evaluation of LNR and modified N stage systems for prognostic stratification of metastatic lymph nodes in stage III colorectal Cancer.Scientific reports · 2025Article
- The current landscape of gastric cancer and gastroesophageal junction cancer diagnosis and treatment in China: a comprehensive nationwide cohort analysis.Journal of hematology & oncology · 2025Article
- Machine learning-based reconstruction of prognostic staging for gastric cancer patients with different differentiation grades: A multicenter retrospective study.World journal of gastroenterology · 2025Article
- Lymph-node ratio as a risk factor for recurrence following neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy for locally advanced esophageal squamous cell carcinoma.Esophagus : official journal of the Japan Esophageal Society · 2025Article
- Mismatch Repair Status and Lymph Node Ratio in Survival Prediction of Stage II/III Rectal Cancer Patients: A Comprehensive Analysis of a Multi-Center Retrospective Study.Cancer medicine · 2025Article
- Predictive value of preoperative L3-SMI, AGR, and PNI for overall survival in patients undergoing radical gastrectomy for gastric cancer.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2025Article
- Lymph node ratio is a prognostic indicator for locally advanced gastric cancer after neoadjuvant immunochemotherapy.BMC gastroenterology · 2024Article
- Is postoperative adjuvant radiotherapy necessary for patients with esophageal cancer after neoadjuvant chemoradiotherapy? An analysis based on the SEER database.Saudi medical journal · 2024Article
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20 authors.
Funding
Abstract
objectiveThis study aimed to propose a revised ypN (r-ypN) classification based on lymph node ratio (LNR) and to examine its prognostic value in postneoadjuvant esophageal cancer.
backgroundA new postneoadjuvant pathologic (ypTNM) staging classification has been introduced for esophageal cancer. However, the ypN classification currently defined by the number of positive lymph nodes is influenced by the extent of lymphadenectomy.
methodsData on 7195 esophageal cancer patients receiving neoadjuvant chemoradiation were extracted from the National Cancer Database (NCDB). Four r-ypN stages were defined by 3 LNR thresholds (0%, 10%, and 20% using X-tile software). A revised ypTNM (r-ypTNM) classification was developed by solely changing N categories. Kaplan-Meier method and Cox proportional hazards models were used for survival analyses. Akaike information criterion (AIC) and Harrell's concordance index ( C -index) were used to compare the predictive performance of the current and the revised classification. External validation was performed using an independent cohort from the NEOCRTEC5010 clinical trial.
resultsBoth ypN ( P <0.001) and r-ypN ( P <0.001) were independent prognostic factors of overall survival (OS) for esophageal cancer patients. Kaplan-Meier curves demonstrated a better discrimination with r-ypN than ypN categories. Within each ypN category (except ypN3), OS was significantly different comparing r-ypN strata; however, there were no differences between ypN strata within each r-ypN category (except r-ypN3). r-ypN (AIC: 60752 vs 60782; C -index: 0.591 vs 0.587) and r-ypTNM (AIC: 60623 vs 60628; C -index: 0.613 vs 0.610) showed better predictive performance than the current staging system, with a lower AIC (better calibration) and higher C -index (improved discrimination). This advantage was also confirmed by external validation using the NEOCRTEC5010 cohort.
conclusionsLNR showed better performance than ypN in predicting OS of esophageal cancer patients after neoadjuvant chemoradiation and may be an improvement on the current staging system.
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