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Screening and validation of a novel T stage-lymph node ratio classification for operable colon cancer.
Pei, Jun-Peng; Zhang, Rui; Zhang, Nan-Nan; Zeng, Yong-Ji; Sun, Zhe; Ma, Si-Ping; Zhou, Jian-Guo; Li, Xin-Xiang; Fan, Jin; Zhu, Ji; Abe, Masanobu; Mei, Zu-Bing; Shi, Gang; Zhang, Chun-Dong.
Afiliación
  • Pei JP; Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
  • Zhang R; Department of Colorectal Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China.
  • Zhang NN; State key Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
  • Zeng YJ; Eppley Institute for Research in Cancer, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska, USA.
  • Sun Z; Department of Colorectal Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China.
  • Ma SP; Department of Colorectal Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China.
  • Zhou JG; Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China.
  • Li XX; Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
  • Fan J; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
  • Zhu J; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
  • Abe M; Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, China.
  • Mei ZB; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
  • Shi G; Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, China.
  • Zhang CD; Division for Health Service Promotion, The University of Tokyo, Tokyo, Japan.
Ann Transl Med ; 9(20): 1513, 2021 Oct.
Article en En | MEDLINE | ID: mdl-34790719
BACKGROUND: Lymph node ratio (LNR) has advantages in predicting prognosis compared with American Joint Committee on Cancer (AJCC) pathological N stage. However, the prognostic value of a novel T stage-lymph node ratio (TLNR) classification for colon cancer combining LNR and pathological primary tumor stage (T stage) is currently unknown. METHODS: We included 62,294 patients with stage I-III colon cancer from the Surveillance, Epidemiology, and End Results Program as a training cohort. External validation was performed in 3,327 additional patients. A novel LNR stage was established and combined with T stage in a novel TLNR classification. Patients with similar survival were grouped according to T and LNR stages, with T1LNR1 as a reference. RESULTS: We developed a novel TLNR classification as follows: stages I (T1LNR1-2, T1LNR4), IIA (T1LNR3, T2LNR1-2, T3LNR1), IIB (T1LNR5, T2LNR3-4, T3LNR2, T4aLNR1), IIC (T2LNR5, T3LNR3-4, T4aLNR2, T4bLNR1), IIIA (T3LNR5, T4aLNR3-4, T4bLNR2), IIIB (T4aLNR5, T4bLNR3-4), and IIIC (T4bLNR5). In the training cohort, the novel TLNR classification had better prognostic discrimination (area under receiver operating characteristic curve, 0.621 vs. 0.608, two-sided P<0.001), superior model-fitting ability for predicting overall survival (Akaike information criteria, 561,129 vs. 562,052), and better net benefits compared with the AJCC 8th tumor/node/metastasis classification. Similar results were found in the validation cohort for predicting both overall and disease-free survival. CONCLUSIONS: This novel TLNR classification may provide better prognostic discrimination, model-fitting ability, and net benefits than the AJCC 8th TNM classification, for potentially better stratification of patients with operable stage I-III colon cancer; however, further studies are required to validate the novel TLNR classification.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies Idioma: En Revista: Ann Transl Med Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: China

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies Idioma: En Revista: Ann Transl Med Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: China