Value of the log odds of positive lymph nodes for prognostic assessment of colon mucinous adenocarcinoma: Analysis and external validation
Abstract Purpose To evaluate the impact of the log odds of positive lymph nodes (LODDS) on cancer‐specific survival (CSS) in colon mucinous adenocarcinoma (MAC) patients, compared with pN stage and the lymph nodes ratio (LNR). Methods A total of 10,182 colon MAC patients from the Surveillance, Epide...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.4366 |
| _version_ | 1819022451848249344 |
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| author | Huajun Cai Tianbao Xu Zhicheng Zhuang Yiyi Zhang Yuan Gao Xing Liu Jinfu Zhuang Yuanfeng Yang Guoxian Guan |
| author_facet | Huajun Cai Tianbao Xu Zhicheng Zhuang Yiyi Zhang Yuan Gao Xing Liu Jinfu Zhuang Yuanfeng Yang Guoxian Guan |
| author_sort | Huajun Cai |
| collection | DOAJ |
| description | Abstract Purpose To evaluate the impact of the log odds of positive lymph nodes (LODDS) on cancer‐specific survival (CSS) in colon mucinous adenocarcinoma (MAC) patients, compared with pN stage and the lymph nodes ratio (LNR). Methods A total of 10,182 colon MAC patients from the Surveillance, Epidemiology, and End Results database were divided into the training group. The external validation group included 153 patients from Fujian Medical University Union Hospital. The Cox regression method was used to identify prognostic risk factors. Nomograms were evaluated by Harrell's concordance index (C‐index) and calibration curves. Recursive partitioning analysis (RPA) was used to develop a novel staging system. Results Time‐dependent receiver operating characteristic curves (ROC) to predict CSS showed the areas under the ROC curve of LODDS were always higher than pN stage and LNR. LNR and LODDS classifications can well distinguish the prognosis of patients with the same pN stage. Cox analyses indicated that age, tumor size, pT stage, pN stage, LNR, and LODDS were independent predictors of CSS (p < 0.05). Based on three lymph nodes classifications, we constructed three prognostic nomograms models for CSS. The C‐index of the pN, LNR, and LODDS classification nomograms were 0.746 (95% confidence interval [95% CI]: 0.736–0.756), 0.750 (95% CI: 0.740–0.760), and 0.758 (95% CI: 0.748–0.768), respectively. In external validation, we observed the C‐index of LODDS classification nomograms was 0.787 (95% CI: 0.648–0.926). RPA stage, including four stages, was constructed successfully based on pT stage and LNR or LODDS, respectively. The 3‐, 5‐, and 8‐year areas under the ROC curve of LNR‐RPA stage and LODDS‐RPA stage were superior to tumor‐node‐metastasis stage. Conclusion LODDS to be a better prognostic factor of CSS for colon MAC patients than pN stage and LNR. A nomogram and RPA stage base on LODDS can provide accurate information for personalized cancer treatment. |
| first_indexed | 2024-12-21T04:23:13Z |
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| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-21T04:23:13Z |
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| spelling | doaj.art-a1b7a9b94e1c475184be482f5e0547b22022-12-21T19:16:07ZengWileyCancer Medicine2045-76342021-12-0110238542855710.1002/cam4.4366Value of the log odds of positive lymph nodes for prognostic assessment of colon mucinous adenocarcinoma: Analysis and external validationHuajun Cai0Tianbao Xu1Zhicheng Zhuang2Yiyi Zhang3Yuan Gao4Xing Liu5Jinfu Zhuang6Yuanfeng Yang7Guoxian Guan8Department of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou ChinaDepartment of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou ChinaDepartment of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou ChinaDepartment of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou ChinaDepartment of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou ChinaDepartment of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou ChinaDepartment of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou ChinaDepartment of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou ChinaDepartment of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou ChinaAbstract Purpose To evaluate the impact of the log odds of positive lymph nodes (LODDS) on cancer‐specific survival (CSS) in colon mucinous adenocarcinoma (MAC) patients, compared with pN stage and the lymph nodes ratio (LNR). Methods A total of 10,182 colon MAC patients from the Surveillance, Epidemiology, and End Results database were divided into the training group. The external validation group included 153 patients from Fujian Medical University Union Hospital. The Cox regression method was used to identify prognostic risk factors. Nomograms were evaluated by Harrell's concordance index (C‐index) and calibration curves. Recursive partitioning analysis (RPA) was used to develop a novel staging system. Results Time‐dependent receiver operating characteristic curves (ROC) to predict CSS showed the areas under the ROC curve of LODDS were always higher than pN stage and LNR. LNR and LODDS classifications can well distinguish the prognosis of patients with the same pN stage. Cox analyses indicated that age, tumor size, pT stage, pN stage, LNR, and LODDS were independent predictors of CSS (p < 0.05). Based on three lymph nodes classifications, we constructed three prognostic nomograms models for CSS. The C‐index of the pN, LNR, and LODDS classification nomograms were 0.746 (95% confidence interval [95% CI]: 0.736–0.756), 0.750 (95% CI: 0.740–0.760), and 0.758 (95% CI: 0.748–0.768), respectively. In external validation, we observed the C‐index of LODDS classification nomograms was 0.787 (95% CI: 0.648–0.926). RPA stage, including four stages, was constructed successfully based on pT stage and LNR or LODDS, respectively. The 3‐, 5‐, and 8‐year areas under the ROC curve of LNR‐RPA stage and LODDS‐RPA stage were superior to tumor‐node‐metastasis stage. Conclusion LODDS to be a better prognostic factor of CSS for colon MAC patients than pN stage and LNR. A nomogram and RPA stage base on LODDS can provide accurate information for personalized cancer treatment.https://doi.org/10.1002/cam4.4366colon mucinous adenocarcinomaLODDSnomogramsprognosisRPA stage |
| spellingShingle | Huajun Cai Tianbao Xu Zhicheng Zhuang Yiyi Zhang Yuan Gao Xing Liu Jinfu Zhuang Yuanfeng Yang Guoxian Guan Value of the log odds of positive lymph nodes for prognostic assessment of colon mucinous adenocarcinoma: Analysis and external validation Cancer Medicine colon mucinous adenocarcinoma LODDS nomograms prognosis RPA stage |
| title | Value of the log odds of positive lymph nodes for prognostic assessment of colon mucinous adenocarcinoma: Analysis and external validation |
| title_full | Value of the log odds of positive lymph nodes for prognostic assessment of colon mucinous adenocarcinoma: Analysis and external validation |
| title_fullStr | Value of the log odds of positive lymph nodes for prognostic assessment of colon mucinous adenocarcinoma: Analysis and external validation |
| title_full_unstemmed | Value of the log odds of positive lymph nodes for prognostic assessment of colon mucinous adenocarcinoma: Analysis and external validation |
| title_short | Value of the log odds of positive lymph nodes for prognostic assessment of colon mucinous adenocarcinoma: Analysis and external validation |
| title_sort | value of the log odds of positive lymph nodes for prognostic assessment of colon mucinous adenocarcinoma analysis and external validation |
| topic | colon mucinous adenocarcinoma LODDS nomograms prognosis RPA stage |
| url | https://doi.org/10.1002/cam4.4366 |
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