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Metastatic lymph node ratio demonstrates better prognostic stratification than pN staging in patients with esophageal squamous cell carcinoma after esophagectomy. | LitMetric

AI Article Synopsis

  • - This study investigated the importance of lymph node ratio (LNR) in predicting survival outcomes for patients with esophageal squamous cell carcinoma (ESCC) by developing a new tumor-ratio-metastasis (TRM) staging system.
  • - Researchers analyzed data from 387 ESCC patients who underwent surgery, determining optimal LNR cut-points and conducting statistical analyses to validate the new staging system's effectiveness.
  • - Findings indicated that the LNR-based TRM stage provided better prognostic accuracy and prediction capabilities compared to traditional N category and TNM staging, significantly impacting overall survival rates.

Article Abstract

This study aimed to evaluate the prognostic significance of lymph node ratio (LNR) by establishing a hypothetical tumor-ratio-metastasis (TRM) staging system in patients with esophageal squamous cell carcinoma (ESCC). The records of 387 ESCC patients receiving curative esophagectomy were retrospectively investigated. The optimal cut-point for LNR was assessed via the best cut-off approach. Potential prognostic parameters were identified through univariate and multivariate analyses. A novel LNR-based TRM stage was proposed. The prognostic discriminatory ability and prediction accuracy of each system were determined using hazard ratio (HR), Akaike information criterion (AIC), concordance index (C-index), and area under the receiver operating characteristic curve (AUC). The optimal cut-points of LNR were set at 0, 0~0.2, 0.2~0.4, and 0.4~1.0. Multivariate Cox analysis indicated that the LNR category was an independent risk factor of overall survival (P < 0.001). The calibration curves for the probability of 3- and 5-year survival showed good consistency between nomogram prediction and actual observation. The LNR category and TRM stage yielded a larger HR, a smaller AIC, a larger C-index, and a larger AUC than the N category and TNM stage did. In summary, the proposed LNR category was superior to the conventional N category in predicting the prognosis of ESCC patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5150247PMC
http://dx.doi.org/10.1038/srep38804DOI Listing

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