Comparison of different lymph node staging systems in prognosis of gastric cancer: a bi-institutional study from Hungary

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摘要 Objective:TheUnionforInternationalCancerControl(UICC)Node(N)classificationisthemostcommonusedstagingmethodfortheprognosisofgastriccancer.Itdemandsadequate,atleast16lymphnodes(LNs)tobedissected;thereforedifferentstagingsystemswereinvented.Methods:BetweenMarch2005andMarch2010,164patientswereevaluatedattheDepartmentofGeneralSurgeryintheKenézyGyulaHospitalandattheDepartmentofGeneral,ThoracicandVascularSurgeryintheKaposiMórHospital.The6th,7thand8thUICCN-stagingsystems,thenumberofexaminedLNs,thenumberofharvestednegativeLNs,themetastaticlymphnoderatio(MLR)andthelogoddsofpositiveLNs(LODDS)weredeterminedtomeasuretheir5-yearsurvivalratesandtocomparethemtoeachother.Results:Theoverall5-yearsurvivalrateforallpatientswas55.5%withamedianoverallsurvivaltimeof102months.Thetumorstage,gender,UICCN-stages,MLRandtheLODDSweresignificantprognosticfactorsforthe5-yearsurvivalwithunivariateanalysis.The6thUICCN-stagedidnotfollowtheadequateriskincomparingN2vs.N0andN3vs.N0withmultivariateinvestigation.ComparisonofperformancesoftheresidualNclassificationsprovedthattheLODDSsystemwasfirstinthepredictionofprognosisduringtheevaluationofallpatientsandincaseswithlessthan16harvestedLNs.TheMLRgavethebestprognosticpredictionwhenadequate(morethanorequalto16)lymphadenectomywasperformed.Conclusions:WesuggesttheapplicationofLODDSsystemroutinelyinwesternpatientsandtheusageofMLRclassificationincaseswithextendedlymphadenectomy.
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出版日期 2017年04月14日(中国期刊网平台首次上网日期,不代表论文的发表时间)
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