Log odds of positive lymph nodes predicts survival in patients treated with neoadjuvant therapy followed by esophagectomy

Abstract

Background and Objectives: We aimed to evaluate the efficacy of the log odds of positive lymph nodes (LODDS) in survival prediction of patients with esophageal carcinoma receiving neoadjuvant therapy, compared with N descriptor and positive lymph node ratio (LNR). Methods: Patients with esophageal carcinoma receiving neoadjuvant therapy from 2004 to 2015 were reviewed in Surveillance, Epidemiology, and End Results database. The receiver operating characteristics curve and area under the curve (AUC) were used to compare discriminatory power among N descriptor, LNR, and LODDS. The goodness of fit was measured using the −2 log-likelihood ratio (-2LLR). Results: About 2239 patients with a 22 months median follow-up and a 37.8% 5-year overall survival rate were included. LODDS had the best discriminatory power and goodness of fit (LODDS vs N descriptor, AUC 0.666 vs 0.626, −2LLR 15 680.402 vs 15 746.162; LODDS vs LNR, AUC 0.666 vs 0.635, −2LLR 15 680.402 vs 15 712.379; all P < .001). LODDS was the best for fewer than 15 lymph nodes retrieved (LODDS vs N descriptor, AUC 0.652 vs 0.618, P < .001; LODDS vs LNR, AUC 0.652 vs 0.625, P = .005). The prognosis of patients without metastatic nodes could be discriminated by LODDS. Conclusions: LODDS could better predict survival of patients with esophageal carcinoma receiving neoadjuvant therapy. K E Y W O R D S esophageal carcinoma, log odds of positive lymph nodes, neoadjuvant therapy

Lymph node status and its impact on the prognosis of left‐sided and right‐sided colon cancer: A SEER population‐based study

“…Pei et al 24 reported that LODDS showed the best accurate ability to predict the survival of CRC patients. Ye et al reported similar results in esophageal carcinoma, demonstrating that the prognostic efficacy of LODDS is superior to that of the N descriptor and LNR for estimating OS 25 . We showed that LCC patients were more in LODDS ≥ −0.9 sub, which might be related to the different sensitivity to immunotherapy between LCC and RCC, and this was not observed in N stage and LNR subs.…”

“…Ye et al reported similar results in esophageal carcinoma, demonstrating that the prognostic efficacy of LODDS is superior to that of the N descriptor and LNR for estimating OS. 25 We showed that LCC patients were more in LODDS ≥ −0.9 sub, which might be related to the different sensitivity to immunotherapy between LCC and RCC, and this was not observed in N stage and LNR subs. Above all, these indicate that the discriminative power of LODDS is superior to N stage and LNR.…”

Evaluation of log odds of positive lymph nodes in predicting the survival of patients with non-small cell lung cancer treated with neoadjuvant therapy and surgery: a SEER cohort-based study

“…For the N descriptor, the lymph node (LN) is based on the lymphatic region involved without any information of the number of dissected LNs (NDLN) and the number of positive LNs (NPLN) [ 7 ]. The log odds of positive LNs (LODDS) is a novel LN descriptor that has advantages over the N stating descriptor of the TNM system in many malignancies, including rectal cancer [ 8 ], gallbladder cancer [ 9 ], gastric adenocarcinoma [ 10 ], cervical cancer [ 11 ], and esophageal carcinoma [ 12 ]. LODDS is calculated using the following formula: ln([NPLN + 0.5]/[NDLN-NPLN + 0.5]).…”

The Evaluation of a SEER-Based Nomogram in Predicting the Survival of Patients Treated with Neoadjuvant Therapy Followed by Esophagectomy

“…The log odds of positive lymph nodes (LODDS), defined as the natural logarithm of the ratio of a metastatic lymph node to a non-metastatic lymph node, has been emerging as an essential prognostic factor for cancer prognosis, including colon cancer ( 9 ), breast cancer ( 10 ), oral squamous cell ( 11 ), lung squamous cell carcinoma ( 12 ), and so on. For esophageal carcinoma, LODDS also exhibits better discrimination power in risk stratification than N descriptor and positive lymph node ratio (LNR) ( 13 ). Ye and his colleagues also developed a nomogram based on the Surveillance, Epidemiology, and End Results (SEER) database, which integrated age, gender, histological grade, T stage, and LODDS as the risk factor, with a C-index of 0.647 ( 13 ).…”