Cargando…
Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer
BACKGROUND: The prognostic performance of four lymph node classifications, the 8th American Joint Committee on Cancer (AJCC) Tumor Node Metastasis (TNM) N stage, lymph node ratio (LNR), log odds of positive lymph nodes (LODDS), and examined lymph nodes (ELN) in early-onset pancreatic cancer (EOPC) r...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9479329/ https://www.ncbi.nlm.nih.gov/pubmed/36119520 http://dx.doi.org/10.3389/fonc.2022.975846 |
_version_ | 1784790764902940672 |
---|---|
author | Zheng, Yangyang Lu, Zhenhua Shi, Xiaolei Tan, Tianhua Xing, Cheng Xu, Jingyong Cui, Hongyuan Song, Jinghai |
author_facet | Zheng, Yangyang Lu, Zhenhua Shi, Xiaolei Tan, Tianhua Xing, Cheng Xu, Jingyong Cui, Hongyuan Song, Jinghai |
author_sort | Zheng, Yangyang |
collection | PubMed |
description | BACKGROUND: The prognostic performance of four lymph node classifications, the 8th American Joint Committee on Cancer (AJCC) Tumor Node Metastasis (TNM) N stage, lymph node ratio (LNR), log odds of positive lymph nodes (LODDS), and examined lymph nodes (ELN) in early-onset pancreatic cancer (EOPC) remains unclear. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was searched for patients with EOPC from 2004 to 2016. 1048 patients were randomly divided into training (n = 733) and validation sets (n = 315). The predictive abilities of the four lymph node staging systems were compared using the Akaike information criteria (AIC), receiver operating characteristic area under the curve (AUC), and C-index. Multivariate Cox analysis was performed to identify independent risk factors. A nomogram based on lymph node classification with the strongest predictive ability was established. The nomogram’s precision was verified by the C-index, calibration curves, and AUC. Kaplan–Meier analysis and log-rank tests were used to compare differences in survival at each stage of the nomogram. RESULTS: Compared with the 8th N stage, LODDS, and ELN, LNR had the highest C-index and AUC and the lowest AIC. Multivariate analysis showed that N stage, LODDS, LNR were independent risk factors associated with cancer specific survival (CSS), but not ELN. In the training set, the AUC values for the 1-, 3-, and 5-year CSS of the nomogram were 0.663, 0.728, and 0.760, respectively and similar results were observed in the validation set. In addition, Kaplan–Meier survival analysis showed that the nomogram was also an important factor in the risk stratification of EOPC. CONCLUSION: We analyzed the predictive power of the four lymph node staging systems and found that LNR had the strongest predictive ability. Furthermore, the novel nomogram prognostic staging mode based on LNR was also an important factor in the risk stratification of EOPC. |
format | Online Article Text |
id | pubmed-9479329 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-94793292022-09-17 Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer Zheng, Yangyang Lu, Zhenhua Shi, Xiaolei Tan, Tianhua Xing, Cheng Xu, Jingyong Cui, Hongyuan Song, Jinghai Front Oncol Oncology BACKGROUND: The prognostic performance of four lymph node classifications, the 8th American Joint Committee on Cancer (AJCC) Tumor Node Metastasis (TNM) N stage, lymph node ratio (LNR), log odds of positive lymph nodes (LODDS), and examined lymph nodes (ELN) in early-onset pancreatic cancer (EOPC) remains unclear. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was searched for patients with EOPC from 2004 to 2016. 1048 patients were randomly divided into training (n = 733) and validation sets (n = 315). The predictive abilities of the four lymph node staging systems were compared using the Akaike information criteria (AIC), receiver operating characteristic area under the curve (AUC), and C-index. Multivariate Cox analysis was performed to identify independent risk factors. A nomogram based on lymph node classification with the strongest predictive ability was established. The nomogram’s precision was verified by the C-index, calibration curves, and AUC. Kaplan–Meier analysis and log-rank tests were used to compare differences in survival at each stage of the nomogram. RESULTS: Compared with the 8th N stage, LODDS, and ELN, LNR had the highest C-index and AUC and the lowest AIC. Multivariate analysis showed that N stage, LODDS, LNR were independent risk factors associated with cancer specific survival (CSS), but not ELN. In the training set, the AUC values for the 1-, 3-, and 5-year CSS of the nomogram were 0.663, 0.728, and 0.760, respectively and similar results were observed in the validation set. In addition, Kaplan–Meier survival analysis showed that the nomogram was also an important factor in the risk stratification of EOPC. CONCLUSION: We analyzed the predictive power of the four lymph node staging systems and found that LNR had the strongest predictive ability. Furthermore, the novel nomogram prognostic staging mode based on LNR was also an important factor in the risk stratification of EOPC. Frontiers Media S.A. 2022-09-02 /pmc/articles/PMC9479329/ /pubmed/36119520 http://dx.doi.org/10.3389/fonc.2022.975846 Text en Copyright © 2022 Zheng, Lu, Shi, Tan, Xing, Xu, Cui and Song https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Zheng, Yangyang Lu, Zhenhua Shi, Xiaolei Tan, Tianhua Xing, Cheng Xu, Jingyong Cui, Hongyuan Song, Jinghai Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer |
title | Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer |
title_full | Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer |
title_fullStr | Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer |
title_full_unstemmed | Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer |
title_short | Lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer |
title_sort | lymph node ratio is a superior predictor in surgically treated early-onset pancreatic cancer |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9479329/ https://www.ncbi.nlm.nih.gov/pubmed/36119520 http://dx.doi.org/10.3389/fonc.2022.975846 |
work_keys_str_mv | AT zhengyangyang lymphnoderatioisasuperiorpredictorinsurgicallytreatedearlyonsetpancreaticcancer AT luzhenhua lymphnoderatioisasuperiorpredictorinsurgicallytreatedearlyonsetpancreaticcancer AT shixiaolei lymphnoderatioisasuperiorpredictorinsurgicallytreatedearlyonsetpancreaticcancer AT tantianhua lymphnoderatioisasuperiorpredictorinsurgicallytreatedearlyonsetpancreaticcancer AT xingcheng lymphnoderatioisasuperiorpredictorinsurgicallytreatedearlyonsetpancreaticcancer AT xujingyong lymphnoderatioisasuperiorpredictorinsurgicallytreatedearlyonsetpancreaticcancer AT cuihongyuan lymphnoderatioisasuperiorpredictorinsurgicallytreatedearlyonsetpancreaticcancer AT songjinghai lymphnoderatioisasuperiorpredictorinsurgicallytreatedearlyonsetpancreaticcancer |