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Validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients

BACKGROUND: To investigate the prognostic value of six lymph nodes (LNs) staging systems: TNM pN stage, 2018 Federation International of Gynecology and Obstetrics (FIGO) stage, number of positive LNs (PLN), number of negative LNs (NLN), metastatic LN ratio (LNR), and log odds of positive LNs (LODDS)...

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Autores principales: Guo, Qinhao, Zhu, Jun, Wu, Yong, Wen, Hao, Xia, Lingfang, Ju, Xingzhu, Ke, Guihao, Wu, Xiaohua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210123/
https://www.ncbi.nlm.nih.gov/pubmed/32395529
http://dx.doi.org/10.21037/atm.2020.03.27
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author Guo, Qinhao
Zhu, Jun
Wu, Yong
Wen, Hao
Xia, Lingfang
Ju, Xingzhu
Ke, Guihao
Wu, Xiaohua
author_facet Guo, Qinhao
Zhu, Jun
Wu, Yong
Wen, Hao
Xia, Lingfang
Ju, Xingzhu
Ke, Guihao
Wu, Xiaohua
author_sort Guo, Qinhao
collection PubMed
description BACKGROUND: To investigate the prognostic value of six lymph nodes (LNs) staging systems: TNM pN stage, 2018 Federation International of Gynecology and Obstetrics (FIGO) stage, number of positive LNs (PLN), number of negative LNs (NLN), metastatic LN ratio (LNR), and log odds of positive LNs (LODDS) in cervical squamous cell carcinoma (CSCC) patients following radical surgery. METHODS: The records of 3,732 CSCC patients who underwent radical surgery between 2006 and 2014 were retrospectively reviewed. We divided variables into different groups by applying tree-based recursive partitioning. Survival curves were compared by the log-rank test, and prognostic factors were identified through Cox regression analysis. The six staging systems underwent assessment for their relative discriminative abilities by way of Harrell’s concordance index (C-index) and the Akaike’s Information Criterion (AIC). RESULTS: All of the six staging systems had a significant influence on patients’ progression-free survival (PFS) and overall survival (OS), with univariate analysis showing all of the staging systems to have the significant prognostic ability in relation to PFS and OS (P<0.001 for each). Multivariate analysis demonstrated five of the staging methods to be independent prognostic factors, but that NLN classification was not. PLN was noted to have somewhat the best prognostic performance for both PFS (C-index: 0.634; AIC: 33,343.83) and OS (C-index: 0.675; AIC: 34,223.11). CONCLUSIONS: The pN, 2018 FIGO stage, PLN, LNR, and LODDS appeared to predict better survival than the NLN in CSCC patients. Moreover, PLN appeared to be the most valuable and predictive LN staging system.
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spelling pubmed-72101232020-05-11 Validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients Guo, Qinhao Zhu, Jun Wu, Yong Wen, Hao Xia, Lingfang Ju, Xingzhu Ke, Guihao Wu, Xiaohua Ann Transl Med Original Article BACKGROUND: To investigate the prognostic value of six lymph nodes (LNs) staging systems: TNM pN stage, 2018 Federation International of Gynecology and Obstetrics (FIGO) stage, number of positive LNs (PLN), number of negative LNs (NLN), metastatic LN ratio (LNR), and log odds of positive LNs (LODDS) in cervical squamous cell carcinoma (CSCC) patients following radical surgery. METHODS: The records of 3,732 CSCC patients who underwent radical surgery between 2006 and 2014 were retrospectively reviewed. We divided variables into different groups by applying tree-based recursive partitioning. Survival curves were compared by the log-rank test, and prognostic factors were identified through Cox regression analysis. The six staging systems underwent assessment for their relative discriminative abilities by way of Harrell’s concordance index (C-index) and the Akaike’s Information Criterion (AIC). RESULTS: All of the six staging systems had a significant influence on patients’ progression-free survival (PFS) and overall survival (OS), with univariate analysis showing all of the staging systems to have the significant prognostic ability in relation to PFS and OS (P<0.001 for each). Multivariate analysis demonstrated five of the staging methods to be independent prognostic factors, but that NLN classification was not. PLN was noted to have somewhat the best prognostic performance for both PFS (C-index: 0.634; AIC: 33,343.83) and OS (C-index: 0.675; AIC: 34,223.11). CONCLUSIONS: The pN, 2018 FIGO stage, PLN, LNR, and LODDS appeared to predict better survival than the NLN in CSCC patients. Moreover, PLN appeared to be the most valuable and predictive LN staging system. AME Publishing Company 2020-04 /pmc/articles/PMC7210123/ /pubmed/32395529 http://dx.doi.org/10.21037/atm.2020.03.27 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Guo, Qinhao
Zhu, Jun
Wu, Yong
Wen, Hao
Xia, Lingfang
Ju, Xingzhu
Ke, Guihao
Wu, Xiaohua
Validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients
title Validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients
title_full Validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients
title_fullStr Validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients
title_full_unstemmed Validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients
title_short Validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients
title_sort validation of the prognostic value of various lymph node staging systems for cervical squamous cell carcinoma following radical surgery: a single-center analysis of 3,732 patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210123/
https://www.ncbi.nlm.nih.gov/pubmed/32395529
http://dx.doi.org/10.21037/atm.2020.03.27
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