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首页> 外文期刊>EBioMedicine >Comparison of three lymph node staging schemes for predicting the outcome in patients with small bowel adenocarcinoma: A population-based cohort and international multicentre cohort study
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Comparison of three lymph node staging schemes for predicting the outcome in patients with small bowel adenocarcinoma: A population-based cohort and international multicentre cohort study

机译：三种预测小肠腺癌预后的淋巴结分期方案的比较：一项基于人群的队列研究和一项国际多中心队列研究

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Background The prognostic roles of three common lymph node staging schemes, number of positive lymph nodes (pN), lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) in small bowel adenocarcinoma (SBA) are unclear. We assessed their prognostic ability in SBA. Methods A total of 2128 patients diagnosed with SBA between 1988 and 2010 from the Surveillance, Epidemiology, and End Results (SEER) database and 186 patients from 15 hospitals in France and China were identified. We evaluated the prognostic ability of the schemes in both continuous and stratified patterns using Rsup2/sup, Harrell's C, and time-dependent receiver operating characteristic curve analyses. Findings For continuous pattern, the LODDS had a better capacity of discrimination and higher accuracy of prognosis than pN and LNR. Similarly, the stratified LODDS classification had a better performance of discrimination and higher accuracy of prognosis than the pN and LNR classification. The multivariable model using the LODDS classification also showed superiorly predictive accuracy and discriminatory capacity to those of the 7th and, 8th TNM node and LNR classification. These results were fully validated in an independent international multicentre cohort. Interpretation The LODDS scheme showed a better prognostic performance than the LNR or pN schemes in patients with SBA regardless of continuous or stratified pattern. The LODDS scheme could serve as an auxiliary to lymph node staging systems in future revisions of the American Joint Committee on Cancer (AJCC) manual. Fund This work was funded by the Zhejiang Province Natural Science Fund of China.
机译：背景目前尚不清楚三种常见的淋巴结分期方案，小肠腺癌（SBA）的阳性淋巴结数目（pN），淋巴结比率（LNR）和阳性淋巴结对数优势（LODDS）的预后作用。我们评估了他们在SBA中的预后能力。方法从监测，流行病学和最终结果（SEER）数据库中，在1988年至2010年期间共诊断出2128例SBA患者，并从法国和中国的15家医院中鉴定出186例患者。我们使用R 2 ，Harrell's C和随时间变化的接收器工作特性曲线分析评估了该方案在连续和分层模式下的预后能力。发现对于连续型，LODDS的辨别能力和预后准确性均高于pN和LNR。同样，分层的LODDS分类比pN和LNR分类具有更好的判别性能和更高的预后准确性。使用LODDS分类的多变量模型还显示出比第7，第8 TNM节点和LNR分类更好的预测准确性和区分能力。这些结果在一个独立的国际多中心队列中得到了充分验证。解释不论是连续还是分层模式，对于SBA患者，LODDS方案的预后均优于LNR或pN方案。在美国癌症联合委员会（AJCC）手册的未来修订版中，LODDS方案可作为淋巴结分期系统的辅助。基金这项工作由中国浙江省自然科学基金资助。

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