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Superiority of Tumor Location-Modified Lauren Classification System for Gastric Cancer: A Multi-Institutional Validation Analysis
BACKGROUND: The tumor location-modified Lauren classification (mLC) has been proposed recently, but its clinical significance remains under debate. This study aimed to elucidate the clinical relevance of mLC and evaluate its superiority to the Lauren classification (LC) for gastric cancer patients w...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132412/ https://www.ncbi.nlm.nih.gov/pubmed/30051368 http://dx.doi.org/10.1245/s10434-018-6654-8 |
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author | Zhao, Lin-Yong Wang, Jun-Jiang Zhao, Yong-Liang Chen, Xin-Zu Yang, Kun Chen, Xiao-Long Zhang, Wei-Han Liu, Kai Song, Xiao-Hai Zheng, Jia-Bin Zhou, Zong-Guang Yu, Pei-Wu Li, Yong Hu, Jian-Kun |
author_facet | Zhao, Lin-Yong Wang, Jun-Jiang Zhao, Yong-Liang Chen, Xin-Zu Yang, Kun Chen, Xiao-Long Zhang, Wei-Han Liu, Kai Song, Xiao-Hai Zheng, Jia-Bin Zhou, Zong-Guang Yu, Pei-Wu Li, Yong Hu, Jian-Kun |
author_sort | Zhao, Lin-Yong |
collection | PubMed |
description | BACKGROUND: The tumor location-modified Lauren classification (mLC) has been proposed recently, but its clinical significance remains under debate. This study aimed to elucidate the clinical relevance of mLC and evaluate its superiority to the Lauren classification (LC) for gastric cancer patients with gastrectomy. METHODS: This study retrospectively evaluated 2764 consecutive gastric cancer patients from three comprehensive medical institutions. The patients were categorized into training, inner-validation, and independent validation sets. The relationships between mLC and other clinicopathologic factors were analyzed, and independent prognostic factors were identified. Survival prognostic discriminatory ability and predictive accuracy were compared between mLC and LC using the concordance index (C-index) and Akaike’s information criterion (AIC), and a nomogram based on mLC was constructed to compare its prognostic improvement with the tumor-node metastasis (TNM) staging system. RESULTS: A significant association between mLC and gender, age, histologic type, T stage, N stage, and M stage was found. The findings showed that mLC, not LC, is an independent prognostic factor, with a smaller AIC and a higher C-index than LC. The nomogram based on mLC showed a better predictive ability than TNM alone. CONCLUSIONS: Compared with LC, mLC, which could be considered a more reliable prognostic factor, may improve the prognostic discriminatory ability and predictive accuracy for gastric cancer patients with gastrectomy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1245/s10434-018-6654-8) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6132412 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-61324122018-09-14 Superiority of Tumor Location-Modified Lauren Classification System for Gastric Cancer: A Multi-Institutional Validation Analysis Zhao, Lin-Yong Wang, Jun-Jiang Zhao, Yong-Liang Chen, Xin-Zu Yang, Kun Chen, Xiao-Long Zhang, Wei-Han Liu, Kai Song, Xiao-Hai Zheng, Jia-Bin Zhou, Zong-Guang Yu, Pei-Wu Li, Yong Hu, Jian-Kun Ann Surg Oncol Gastrointestinal Oncology BACKGROUND: The tumor location-modified Lauren classification (mLC) has been proposed recently, but its clinical significance remains under debate. This study aimed to elucidate the clinical relevance of mLC and evaluate its superiority to the Lauren classification (LC) for gastric cancer patients with gastrectomy. METHODS: This study retrospectively evaluated 2764 consecutive gastric cancer patients from three comprehensive medical institutions. The patients were categorized into training, inner-validation, and independent validation sets. The relationships between mLC and other clinicopathologic factors were analyzed, and independent prognostic factors were identified. Survival prognostic discriminatory ability and predictive accuracy were compared between mLC and LC using the concordance index (C-index) and Akaike’s information criterion (AIC), and a nomogram based on mLC was constructed to compare its prognostic improvement with the tumor-node metastasis (TNM) staging system. RESULTS: A significant association between mLC and gender, age, histologic type, T stage, N stage, and M stage was found. The findings showed that mLC, not LC, is an independent prognostic factor, with a smaller AIC and a higher C-index than LC. The nomogram based on mLC showed a better predictive ability than TNM alone. CONCLUSIONS: Compared with LC, mLC, which could be considered a more reliable prognostic factor, may improve the prognostic discriminatory ability and predictive accuracy for gastric cancer patients with gastrectomy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1245/s10434-018-6654-8) contains supplementary material, which is available to authorized users. Springer International Publishing 2018-07-26 2018 /pmc/articles/PMC6132412/ /pubmed/30051368 http://dx.doi.org/10.1245/s10434-018-6654-8 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Gastrointestinal Oncology Zhao, Lin-Yong Wang, Jun-Jiang Zhao, Yong-Liang Chen, Xin-Zu Yang, Kun Chen, Xiao-Long Zhang, Wei-Han Liu, Kai Song, Xiao-Hai Zheng, Jia-Bin Zhou, Zong-Guang Yu, Pei-Wu Li, Yong Hu, Jian-Kun Superiority of Tumor Location-Modified Lauren Classification System for Gastric Cancer: A Multi-Institutional Validation Analysis |
title | Superiority of Tumor Location-Modified Lauren Classification System for Gastric Cancer: A Multi-Institutional Validation Analysis |
title_full | Superiority of Tumor Location-Modified Lauren Classification System for Gastric Cancer: A Multi-Institutional Validation Analysis |
title_fullStr | Superiority of Tumor Location-Modified Lauren Classification System for Gastric Cancer: A Multi-Institutional Validation Analysis |
title_full_unstemmed | Superiority of Tumor Location-Modified Lauren Classification System for Gastric Cancer: A Multi-Institutional Validation Analysis |
title_short | Superiority of Tumor Location-Modified Lauren Classification System for Gastric Cancer: A Multi-Institutional Validation Analysis |
title_sort | superiority of tumor location-modified lauren classification system for gastric cancer: a multi-institutional validation analysis |
topic | Gastrointestinal Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132412/ https://www.ncbi.nlm.nih.gov/pubmed/30051368 http://dx.doi.org/10.1245/s10434-018-6654-8 |
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