Log odds of positive lymph nodes is a better prognostic factor for oesophageal signet ring cell carcinoma than N stage  

作　　者：Feng Wang Shu-Geng Gao Qi Xue Feng-Wei Tan Yu-Shun Gao You-Sheng Mao Da-Li Wang Jun Zhao Yin Li Xiang-Yang Yu Hong Cheng Chen-Guang Zhao Ju-Wei Mu 

机构地区：[1]Department of Thoracic Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China

出　　处：《World Journal of Clinical Cases》2021年第1期24-35,共12页世界临床病例杂志

基　　金：Capital Health Development Research Project,No.2014-1-4021.

摘　　要：BACKGROUND Signet ring cell carcinoma is a rare type of oesophageal cancer,and we hypothesized that log odds of positive lymph nodes(LODDS)is a better prognostic factor for oesophageal signet ring cell carcinoma.AIM To explore a novel prognostic factor for oesophageal signet ring cell carcinoma by comparing two lymph node-related prognostic factors,log odds of positive LODDS and N stage.METHODS A total of 259 cases of oesophageal signet ring cell carcinoma after oesophagectomy were obtained from the Surveillance,Epidemiology,and End Results database between 2006 and 2016.The prognostic value of LODDS and N stage for oesophageal signet ring cell carcinoma was evaluated by univariate and multivariate analyses.The Akaike information criterion and Harrell’s C-index were used to assess the value of two prediction models based on lymph nodes.External validation was performed to further confirm the conclusion.RESULTS The 5-year cancer-specific survival(CSS)and 5-year overall survival(OS)rates of all the cases were 41.3%and 27.0%,respectively.The Kaplan-Meier method showed that LODDS had a higher score of log rank chi-squared(OS:46.162,CSS:41.178)than N stage(OS:36.215,CSS:31.583).Univariate analyses showed that insurance,race,T stage,M stage,TNM stage,radiation therapy,N stage,and LODDS were potential prognostic factors for OS(P<0.1).The multivariate Cox regression model showed that LODDS was an significant independent prognostic factor for oesophageal signet ring carcinoma patients after surgical resection(P<0.05),while N stage was not considered to be a significant prognostic factor(P=0.122).Model 2(LODDS)had a higher degree of discrimination and fit than Model 1(N stage)(LODDS vs N stage,Harell’s C-index 0.673 vs 0.656,P<0.001;Akaike information criterion 1688.824 vs 1697.519,P<0.001).The results of external validation were consistent with those in the study cohort.CONCLUSION LODDS is a superior prognostic factor to N stage for patients with oesophageal signet ring cell carcinoma after oesophagectomy.

关 键 词：Oesophageal neoplasms Signet ring cell Lymph nodes PROGNOSIS Log odds of positive lymph nodes TNM stage 

分 类 号：R735.1[医药卫生—肿瘤]