The prognostic value of lymph nodes count on survival of patients with node-negative gastric cancer

Zheng, Weifeng; Ji, Tingting; Lin, Yong; Li, Rongzhou

doi:10.18632/oncotarget.9845

Cited by 19 publications

(8 citation statements)

References 26 publications

(27 reference statements)

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“…Additionally, more retrieved LNs represented adequate surgical, pathological and institutional care[ 17 ]. What’s more, anatomic studies determined that more resected LNs could improve the underlying tumor-host interactions and reset the immunological balance to improve survival[ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of lymph nodes count on survival of patients with distal cholangiocarcinomas

Lin

Liu

et al. 2018

WJG

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AIMTo evaluate the prognostic value of the number of retrieved lymph nodes (LNs) and other prognostic factors for patients with distal cholangiocarcinomas, and to determine the optimal retrieved LNs cut-off number.METHODSThe Surveillance, Epidemiology and End Results database was used to screen for patients with distal cholangiocarcinoma. Patients with different numbers of retrieved LNs were divided into three groups by the X-tile program. X-tile from Yale University is a useful tool for outcome-based cut-point optimization. The Kaplan-Meier method and Cox regression analysis were utilized for survival analysis.RESULTSA total of 449 patients with distal cholangiocarcinoma met the inclusion criteria. The Kaplan-Meier survival analysis for all patients and for N1 patients revealed no significant differences among patients with different retrieved LN counts in terms of overall and cancer-specific survival. In patients with node-negative distal cholangiocarcinoma, patients with four to nine retrieved LNs had a significantly better overall (P = 0.026) and cancer-specific survival (P = 0.039) than others. In the subsequent multivariate analysis, the number of retrieved LNs was evaluated to be independently associated with survival. Additionally, patients with four to nine retrieved LNs had a significantly lower overall mortality risk [hazard ratio (HR) = 0.39; 95% confidence interval (CI): 0.20-0.74] and cancer cause-specific mortality risk (HR = 0.32; 95%CI: 0.15-0.66) than other patients. Additionally, stratified survival analyses showed persistently better overall and cancer-specific survival when retrieving four to nine LNs in patients with any T stage of tumor, a tumor between 20 and 50 mm in diameter, or a poorly differentiated or undifferentiated tumor, and in patients who were ≤ 70-years-old.CONCLUSIONThe number of retrieved LNs was an important independent prognostic factor for patients with node-negative distal cholangiocarcinoma. Additionally, patients with four to nine retrieved LNs had better overall and cancer-specific survival rates than others, but the reason and mechanism were unclear. This conclusion should be validated in future studies.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of lymph nodes count on survival of patients with distal cholangiocarcinomas

Lin

Liu

et al. 2018

WJG

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“…Lymph node count is a prognostic factor in node-negative gastric cancer and other malignancies with intraperitoneal and lymphatic spread. 22 …”

Section: Discussionmentioning

confidence: 99%

Association of Lymph Node Count and Overall Survival in Node-Negative Endometrial Cancers

Seagle

Gilchrist-Scott

Graves

et al. 2017

JCO Clinical Cancer Informatics

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Purpose To estimate whether the number of lymph nodes removed during surgery is associated with overall survival among women with endometrial cancer. Methods We performed a retrospective cohort study of women with node-negative, stage I to IIIB endometrial cancer (n = 152,702) identified from the 1998–2011 National Cancer Database. Multivariable Cox proportional hazards regression tested for an association of lymph node count with survival. Restricted mean survival and relative hazard curves were plotted for survival as a function of number of removed lymph nodes. Results Among women with node-negative endometrioid endometrial cancer, for each additional five lymph nodes removed, the hazard for death decreased: stage I, the hazard ratio (HR) was 0.95 (95% CI, 0.93 to 0.97; P < .001), stage II, HR was 0.90 (95% CI, 0.87 to 0.94; P < .001); and stage IIIA-B, HR was 0.92 (95% CI, 0.88 to 0.96; P < .001). When grouped by grade, each additional five lymph nodes removed was also associated with decreased hazard for death: grade 1, HR was 0.96 (95% CI, 0.93 to 0.99; P = .009); grade 2,HR was0.91 (95%CI, 0.89 to0.94; P <.001);and grade 3,HR was 0.95 (95%CI, 0.92 to 0.97; P <.001). Increased lymph node dissection was also associated with increased survival among women with node-negative stage II (HR, 0.92; 95% CI, 0.86 to 0.98; P = .01) or stage IIIA-B (HR, 0.94; 95% CI, 0.89 to 0.99; P = .025) uterine serous carcinoma, but not among women with carcinosarcoma or clear cell adeno-carcinoma. Five-year survival for women with one to four nodes removed and endometrioid or serous histology was 85% (95% CI, 84% to 85%) and 54% (95% CI, 50% to 59%), respectively. Five-year survival was significantly higher for women with ≥ 20 removed nodes and endometrioid (91%; 95% CI, 90% to 91%) or serous (72%; 95% CI, 68% to 76%) histology (P < .001). Conclusion Increased lymph node count is associated with a 1% to 14% decreased hazard of death per each additional five lymph nodes removed and a 5% to 20% increased 5-year survival among women with pathologically node-negative endometrioid and serous endometrial cancers.

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“…According to the current tumor-node-metastasis (TNM) staging system for gastric cancer of the Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) and Japanese Gastric Cancer Association (JGCA) guideline, a minimum of 15 dissected LNs should be collected from gastric cancer samples for accurate histological examination and proper N stage assessment [ 5 - 7 ]. The number of retrieved LN counts was also validated as predictor after radical resection [ 6 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Negative lymph node count is a significant prognostic factor in patient with stage IV gastric cancer after palliative gastrectomy

et al. 2017

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Negative lymph node (NLN) count has been validated as a protective predictor in various cancers after radical resection. However, the prognostic value of NLN count in the setting of stage IV gastric cancer patients who have received palliative resection has not been investigated. Surveillance, Epidemiology, and End Results Program (SEER)-registered gastric cancer patients were used for analysis in this study. Kaplan-Meier survival curves and multivariate Cox proportional hazards model were used to assess the risk factors for patients’ survivals. The results showed that NLN count and N stage were independently prognostic factors in patients with stage IV gastric cancer after palliative surgery (P< 0.001). X-tile plots identified 2 and 11 as the optimal cutoff values to divide the patients into high, middle and low risk subsets in term of cause-specific survival (CSS). And NLN count was proved to be an independently prognostic factor in multivariate Cox analysis (P< 0.001). The risk score of NLN counts demonstrated that the plot of hazard ratios (HRs) for NLN counts sharply increased when the number of NLN counts decreased. Collectively, our present study revealed that NLN count was an independent prognostic predictor in stage IV gastric cancer after palliative resection. Standard lymph node dissection, such as D2 lymphadectomy maybe still necessary during palliative resection for patients with metastatic gastric cancer.

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The prognostic value of lymph nodes count on survival of patients with node-negative gastric cancer

Cited by 19 publications

References 26 publications

Prognostic value of lymph nodes count on survival of patients with distal cholangiocarcinomas

Prognostic value of lymph nodes count on survival of patients with distal cholangiocarcinomas

Association of Lymph Node Count and Overall Survival in Node-Negative Endometrial Cancers

Negative lymph node count is a significant prognostic factor in patient with stage IV gastric cancer after palliative gastrectomy

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