Evidence map›Paper›PMID 36175896›Full record

ArticleWorld journal of surgical oncology2022

Prognostic value of lymph node density on cancer staging system for gastric cancer without distal metastasis: a population-based analysis of SEER database.

Yuhua Liu, Hao Cui, Xinxin Xu, Wenquan Liang

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Article in World journal of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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3 · Its place in the literature

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5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Yuhua Liu *Chinese PLA General Hospital & Medical School of Chinese PLA, Beijing, 100853, China.
Hao Cui *Chinese PLA General Hospital & Medical School of Chinese PLA, Beijing, 100853, China.
Xinxin Xu *Chinese PLA General Hospital & Medical School of Chinese PLA, Beijing, 100853, China.
Wenquan LiangChinese PLA General Hospital & Medical School of Chinese PLA, Beijing, 100853, China. liangwenquan@301hospital.com.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate tumor staging is the cornerstone of tumor treatment. Current tumor staging system for gastric cancer (GC) is based on regional positive lymph nodes while ignoring the total number of examined lymph nodes. We aim to assess the prognostic value of lymph node density (LND), the ratio of positive nodes to the total number examined nodes, in GC without distal metastasis.

methodsClinical information of patients with histologically confirmed GC and without distal metastasis was identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. The X-Tile software was used to identify the ideal prognosis-related cutoff point for LND. The prognostic value of LND on cancer-specific survival (CSS) and overall survival (OS) was assessed in Cox regression models. Subgroup analysis stratified by LND was performed on current lymph node staging system to further explore the interaction between LND and current lymph node staging system.

resultsA total of 4281 participants were identified from the SEER database for the final analysis. The optimal prognosis-related cutoff values of LND were calculated as 0.1 and 0.4, and LND was divided into three levels: LND1 (< 0.1), LND2 (> = 0.1, < 0.4), and LND3 (> = 0.4). LND3 was associated with worse CSS and OS in GC patients. Compared to patients with LND1, those with LND2 and LND3 had 2.43 (HR = 2.43, 95% CI 2.09-2.84, P < 0.001) and 4.69 (HR = 4.69, 95% CI 4.02-5.48, P < 0.001) folds increase in mortality in CSS, respectively. Similar results were found in the evaluation of OS in GC patients. Subgroup analysis stratified by LND also found that patients in the same current lymph node stage still had different prognosis due to the different LND levels after adjustment for other prognosis-related covariates (all P values < 0.001).

conclusionLND is an independent prognostic factor for GC without distal metastasis. In the current lymph node staging system, LND has potential value in further accurately classifying GC patients without distal metastasis.

Indexed as

Stomach NeoplasmsHumansLymphatic MetastasisLymph Node ExcisionLymph NodesNeoplasm StagingPrognosisCancer-specific survivalGastric cancerLymph node densityOverall survivalSEERTumor staging

Identifiers

PMID36175896
PMCPMC9520926

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