Log Odds Could Better Predict Survival in Muscle-Invasive Bladder Cancer Patients Compared with pN and Lymph Node Ratio

Abstract

Background: The aim of this study was to assess the prognostic value of lymph node-associated variables, pN, lymph node ratio (LNR) and log odds (LODDS), in patients with bladder cancer.Methods: In the discovery cohort, 3358 patients with muscle-invasive bladder cancer (MIBC) and treated with radical cystectomy were identified from the Surveillance, Epidemiology, and End Results (SEER) database. A total of 173 patients with MIBC who underwent radical cystectomy at Shanghai Cancer Center between 2010 and 2013 were enrolled in the validation cohort. LNR and LODDS were calculated in two cohorts and prognostic value was compared between these two variables.Results: In the two cohorts, survival differences between LODDS, LNR and pN (from the 7th AJCC TNM system) cohorts were statistically significant. Univariate and multivariate analyses confirmed that LNR and LODDS were independent prognostic factors and LODDS was better at predicting prognosis than pN and LNR for patients with MIBC. Moreover, LODDS had a better discriminative ability and model fit, proven by the highest Harrell's concordance index and lowest AIC among the three variables. Furthermore, scatter plots of pN, LNR and LODDS revealed that several groups of LNR and pN were heterogeneous and could be better stratified by LODDS in terms of prognosis estimation.Conclusion: LODDS has significant prognostic value for patients with MIBC. Moreover, LODDS is better at predicting prognosis for MIBC patients compared with pN and LNR.

Lymph Node Ratio Rather Than Positive Lymph Node Counts Has Better Prognostic Value in Patients With Testicular Germ Cell Tumors

“…LNR, the ratio of positive lymph node counts among the total regional lymph nodes examined in the surgery, has been shown to have prognostic value in various cancers, including lung, 29 , 30 bladder, 31 renal, 32 breast, 33 , 34 colorectal, 16 and gastric 15 cancers. However, its prognostic role in testicular germ cell tumors remains unknown.…”

Development and External Validation of a Novel 12-Gene Signature for Prediction of Overall Survival in Muscle-Invasive Bladder Cancer

“…Leliveld et al reported that pathological TNM stage and age were independent prognosis factors for patients with MIBC who underwent radical cystectomy (20). Jin S et al analyzed lymph node-associated variables [pathological N stage (pN), lymph node ratio (LNR) and log odds (LODDDS)] in the patients with MIBC and found c-index that predicted the survival was 0.6769 (pN), 0.6794 (pN+ LNR), and 0.6855 (pN+LNR+LODDDS) (21). Mitra et al established clinical and genomic classifiers and the c-index was up to 0.73 (18).…”

Identification of Lymph Node Metastasis–Related Key Genes and Prognostic Risk Model in Bladder Cancer by Co-Expression Analysis

“…Lymph node dissection provides accurate node staging and predictive information for oncologic outcomes except for the tumor stage and grade. In addition, several parameters, based on the lymph node status including positive node count, lymph node density, and log odds, were proposed as prognostic factors for BCa patients (Fransen van de Putte et al, 2015;Masson-Lecomte et al, 2013;Lee et al, 2012;Jin et al, 2019).…”