Prognostic value of log odds of positive lymph nodes in node-positive lung squamous cell carcinoma patients after surgery: a SEER population-based study

Abstract

Background: Log odds of positive lymph nodes (LODDS) is a novel and promising ratio-based lymph node (LN) staging system in many malignancies. This study aimed to evaluate the prognostic value of LODDS, and comprehensively compare the prognostic predictive performance of LODDS with the American Joint Committee on Cancer (AJCC) N classification, number of positive lymph node (NPLN), and lymph node ratio (LNR) among node-positive lung squamous cell carcinoma (SCC) patients after surgery.Methods: We identified 2,561 patients with N1/N2 stage SCC diagnosed between 2004 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) database. X-tile analysis was used to calculate the optimal cut-off value for each staging system. Univariable and Multivariable Cox regression analyses were used to assess the association of cancer-specific survival (CSS), and overall survival (OS) with N, NPLN, LNR, and LODDS, separately, and integrally. Moreover, linear trend χ 2 score, likelihood ratio (LR) test, Akaike information criterion (AIC), and Harrell concordance index (C-index) were adopted as criteria for assessing the predictive ability of each model. Results:The optimal cut-off values for NPLN, LNR, and LODDS were 3, 0.28, and −0.37, respectively. N, NPLN, LNR, and LODDS were identified as independent prognostic predictors for CSS and OS in patients with SCC when each of them was incorporated into multivariable Cox model separately. Additionally, LODDS had the higher linear trend χ 2 score, higher LR χ 2 test score, lower AIC, and higher C-index compared to the other three systems. Moreover, a combination of N, NPLN, and LODDS was superior to any staging system alone for predicting prognosis.Conclusions: LODDS showed better predictive performance than N, NPLN, and LNR among patients with node-positive SCC after surgery. A combination of LODDS and the current AJCC TNM classification has the potential for becoming a better staging method to more precisely predicting prognosis.

Dynamic nomograms combining N classification with ratio-based nodal classifications to predict long-term survival for patients with lung adenocarcinoma after surgery: a SEER population-based study

“…We found that NPLN, LODDS and LNR were all independent predictive factors, and LNR was superior to NPLN and LODDS by demonstrating better performance in homogeneity, statistical model fit, discrimination, and accuracy of survival prediction. LODDS was thought to be prognostically superior or equivalent to lymph node ratio in previous lung or digestive cancer studies [ 10 – 13 , 17 , 23 ]. Deng et al studied the predictive performance of LODDS and LNR in patients with node-positive NSCLC and chose 10 as a cutoff value of NDLN [ 11 ].…”

“…Secondly, we separately put NPLN (Model 1), LODDS (Model 2), LNR (Model 3), LODDS+LNR (Model 4) into four different multivariate Cox regression models using Backward LR method. The predictive performance of these models was assessed according to homogeneity, statistical model fit, discrimination, and accuracy [ 17 ]. The likelihood-ratio (LR) χ 2 test was applied to evaluate homogeneity between different models.…”

Prognostic implications of ENE and LODDS in relation to lymph node-positive colorectal cancer location

“…Second, there is no standard staging method for LNR and LODDS, and the staging of our group was based on the retrospective analysis of 2561 lung squamous cell carcinoma patients in the Surveillance, Epidemiology, and End Results (SEER) database by Yu et al. [40] . The findings of this study on the prognosis assessment of LODDS in lymph node-positive CRC patients are consistent with those of Yu et al., but the basis of LODDS grouping deserves further investigation.…”

The prognostic performance of the log odds of positive lymph nodes in patients with esophageal squamous cell carcinoma: A population study of the US SEER database and a Chinese single‐institution cohort

“…32 To date, the LODDS value has been proposed as a novel prognostic indicator that is more accurate than existing indexes in patients with various cancers. 33,34 However, its accuracy in ESCC has yet to be explored. 13,15 The LODDS stage system has potential superiority because it considers both the information of the involved nodes and the NLNs.…”