Patterns of lymph node sampling and the impact of lymph node density in favorable histology Wilms tumor: An analysis of the national cancer database

The impact of the lymph node density on overall survival in patients with Wilms’ tumor: A SEER analysis

“…Moreover, our study did not find a significant association between the number of LNs and survival. This may be because of the following reasons: our study only included SEER data; we excluded patients whose number of LNs examined was 0 because the LND could not be obtained; and the number of LNs examined was analyzed as a continuous variable in this study rather than as a categorical variable, as in the study of Zhuge et al 11 In addition, the results were supported by the study of Saltzman et al 17 Therefore, the relationship between the number of LNs and WT prognosis needs to be further clarified.…”

“… 31 Furthermore, a study including 390 cases from the National Cancer Database published in 2017 suggested that LND might be a prognostic factor for favorable WT histology. 17 However, the association of LND with the prognosis of WT patients still needs to be confirmed. Therefore, we utilized the SEER database to study the impact of LND on overall survival of patients with WT.…”

“…The results showed that age, race, SEER stage, tumor laterality, and LND stratification were significantly associated with poor overall survival of WT patients. Although we used the Classification and Regression Tree method to determine a cutoff point of 0.22 and the study of Saltzman et al 17 used 0.38 as the cutoff point, it was necessary to find the optimal LND cutoff for use in future clinical studies. To make the results more conservative, TLND as a continuous variable, instead of LND stratification, was included for reanalysis by Cox regression.…”

“…In recent years, the lymph node ratio (LNR) or lymph node density (LND) has gained increasing attention in research on rectal cancer, 12 colon cancer, 13 – 16 and other cancers because it has been demonstrated to have a promising prognostic value. A recent study from Saltzman et al 17 indicated that LND was significantly associated with overall survival in a favorable WT-based histology in 390 cases from the National Cancer Database during 2004–2013. However, more evidence is needed to further clarify whether LND is a prognostic factor for WT.…”

Determining the optimal cutoff point for lymph node density and its impact on overall survival in children with Wilms’ tumor

“…Although the overall survival rate exceeds 90% in patients with WT,3 reliable prognostic factors still need to be identified because they can be used to stratify patients in order to further improve the survival rate and reduce the intensity of chemotherapy or radiotherapy in situations where the prognosis is constant. The two recent studies of You et al4 and Saltzman et al5 showed that the lymph node density (LND) defined as the proportion of the number of positive lymph nodes (LNs) relative to the number of examined LNs can be used to stratify the prognosis in WT patients. Nevertheless, the impact of the LND on overall survival in children is unclear since all the previous studies also included adults.…”