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Liu L, Ren J, Wang G, Cui Y, Li F, Wang D, Lei X. Negative Lymph Node Is an Independent Prognostic Factor for Stage III Gastric Cancer Patients After Curative Gastrectomy: A Surveillance, Epidemiology, and End Results-Based Study. Am Surg 2023; 89:4413-4423. [PMID: 35861326 DOI: 10.1177/00031348221114034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Negative lymph node (NLN)' s prognostic impact on stage III gastric cancer (GC) patients after curative gastrectomy has not been rigorously studied. We aimed to explore the relationship between NLNs count and outcomes of stage III GC patients. METHODS We retrospectively investigated stage III gastric cancer cases between 2008 and 2018 from Surveillance, Epidemiology, and End Results (SEER) database. Variables were compared by chi2 test. Kaplan-Meier methods and COX proportional hazard models were used to ascertain independent prognostic factors. Survival differences among the subgroups were analyzed to assess the effects of NLN count on overall survival (OS) in stage III GC patients. RESULTS 2373 patients with curative gastrectomy for stage III GC were identified. Univariate analysis demonstrated that NLNs count >14 was associated better 5-year OS (43.7% VS 23.1%, P< .001) comparing with the NLNs count ≤ 14. Subgroup analysis showed that the NLNs count could predict survival in both node-negative and node-positive patients. Multivariate analysis revealed NLNs count is an independent prognostic factor. CONCLUSIONS The NLNs count is an independent prognostic factor for survival in stage III gastric cancer patients after curative gastrectomy and should be recommended for clinical applications.
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Affiliation(s)
- Linmei Liu
- Department of Traditional Chinese Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jigang Ren
- Department of Traditional Chinese Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Guan Wang
- Health Management Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yingjuan Cui
- Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Fang Li
- Department of Traditional Chinese Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Daxue Wang
- Department of Traditional Chinese Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiao Lei
- Department of Traditional Chinese Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Huang X, Luo Z, Liang W, Xie G, Lang X, Gou J, Liu C, Xu X, Fu D. Survival Nomogram for Young Breast Cancer Patients Based on the SEER Database and an External Validation Cohort. Ann Surg Oncol 2022; 29:5772-5781. [PMID: 35661275 PMCID: PMC9356966 DOI: 10.1245/s10434-022-11911-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/03/2022] [Indexed: 12/21/2022]
Abstract
Background Young breast cancer (YBC) patients are more prone to lymph node metastasis than other age groups. Our study aimed to investigate the predictive value of lymph node ratio (LNR) in YBC patients and create a nomogram to predict overall survival (OS), thus helping clinical diagnosis and treatment. Methods Patients diagnosed with YBC between January 2010 and December 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were enrolled and randomly divided into a training set and an internal validation set with a ratio of 7:3. An independent cohort from our hospital was used for external validation. Univariate and least absolute shrinkage and selection operator (LASSO) regression were used to identify the significant factors associated with prognosis, which were used to create a nomogram for predicting 3- and 5-year OS. Results We selected seven survival predictors (tumor grade, T-stage, N-stage, LNR, ER status, PR status, HER2 status) for nomogram construction. The C-indexes in the training set, the internal validation set, and the external validation set were 0.775, 0.778 and 0.817, respectively. The nomogram model was well calibrated, and the time-dependent ROC curves verified the superiority of our model for clinical usefulness. In addition, the nomogram classification could more precisely differentiate risk subgroups and improve the discrimination of YBC prognosis. Conclusions LNR is a strong predictor of OS in YBC patients. The novel nomogram based on LNR is a reliable tool to predict survival, which may assist clinicians in identifying high-risk patients and devising individual treatments.
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Affiliation(s)
- Xiao Huang
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Zhou Luo
- Department of Breast Surgery, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China
| | - Wei Liang
- Graduate School, Dalian Medical University, Dalian, China
| | - Guojian Xie
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Xusen Lang
- Graduate School, Dalian Medical University, Dalian, China
| | - Jiaxiang Gou
- Graduate School, Dalian Medical University, Dalian, China
| | - Chenxiao Liu
- Graduate School, Dalian Medical University, Dalian, China
| | - Xiangnan Xu
- Department of Breast Surgery, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China
| | - Deyuan Fu
- Department of Breast Surgery, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China.
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Wu LL, Zhong JD, Zhu JL, Kang L, Huang YY, Lin P, Long H, Zhang LJ, Ma QL, Qiu LH, Ma GW. Postoperative survival effect of the number of examined lymph nodes on esophageal squamous cell carcinoma with pathological stage T1–3N0M0. BMC Cancer 2022; 22:118. [PMID: 35090428 PMCID: PMC8800278 DOI: 10.1186/s12885-022-09207-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 01/12/2022] [Indexed: 12/31/2022] Open
Abstract
Background The postoperative survival effect of the number of examined lymph nodes on patients of R0-resected esophageal squamous cell carcinoma with pathological stage T1–3N0M0 is still unclear. Methods Patients diagnosed with pathological stage T1–3N0M0 esophageal squamous cell carcinoma from two cancer databases—our cancer center (N = 707), and Surveillance Epidemiology and End Results (N = 151). The primary clinical endpoint was overall survival. The X-tile software was used to determine the optimal cutoff value of the number of examined lymph nodes, and propensity score matching was conducted to reduce selection bias according to the results of X-tile software. The cohort of 151 patients from another database was used for validation. Results X-tile software provided an optimal cutoff value of 15 examined lymph nodes based on 707 patients, and 231 pairs of matched patients were included. In the unmatched cohort, Cox proportional hazard regression analysis revealed better overall survival in patients with more than 15 examined lymph nodes (adjusted hazard ratio, 0.566, 95% confidence interval, 0.445–0.720; p < 0.001) compared with patients with 15 or fewer examined lymph nodes. In the validation cohort, patients with more than 15 examined lymph nodes also had better overall survival (adjusted hazard ratio 0.665, p = 0.047). Conclusions The number of examined lymph nodes is a significant prognostic factor in esophageal squamous cell carcinoma patients with pathological stage T1–3N0M0, and more than 15 examined lymph nodes are associated with better overall survival. Although the difference is not significant, the survival curve of patients with examined lymph nodes > 30 is better than those with examined lymph nodes 15–30. We believe that the number of examined lymph nodes can provide prognostic guidance for those patients, and the more examined lymph nodes cause lesser occult lymph nodes metastasis and lead to a better prognosis. Therefore, surgeons and pathologists should try to examine as many lymph nodes as possible to evaluate the pathological stage precisely. However, we need more validation from other studies.
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The prognostic value of lymph node ratio in comparison to positive lymph node count in penile squamous cell carcinoma. Int Urol Nephrol 2021; 53:2527-2540. [PMID: 34585313 PMCID: PMC8599252 DOI: 10.1007/s11255-021-02996-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/12/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE Penile cancer is a rare male neoplasm with a wide variation in its global incidence. In this study, the prognostic value of lymph node ratio (LNR) was compared to that of positive lymph node count (PLNC) in penile squamous cell carcinoma. METHODS A total of 249 patients with penile squamous cell carcinoma were enrolled from The Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. The X-tile program was used to calculate the optimal cut-off values of LNR and PLNC that discriminate survival. We used the χ2 or the Fisher exact probability test to assess the association between clinical-pathological characteristics and LNR or PLNC. Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors for survival. Spearman correlation analysis was used to determine the correlation between LNR and PLNC. RESULTS We found that patients with high LNR tended to have advanced N stage, the 7th AJCC stage, and higher pathological grade, while patients with high PLNC had advanced N stage and the 7th AJCC stage. Univariate Cox regression analysis revealed that the N stage, M stage, the 7th AJCC stage, lymph-vascular invasion, LNR, and PLNC were significantly associated with prognosis. Multivariate Cox regression analysis demonstrated that LNR rather than PLNC was an independent prognostic factor for cancer-specific survival. Subgroup analysis of node-positive patients showed that LNR was associated with CSS, while PLNC was not. CONCLUSION LNR was a better predictor for long-term prognosis than PLNC in patients with penile squamous cell carcinoma.
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Male breast cancer: an update. Virchows Arch 2021; 480:85-93. [PMID: 34458944 DOI: 10.1007/s00428-021-03190-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/23/2021] [Accepted: 08/03/2021] [Indexed: 12/13/2022]
Abstract
Male breast cancer (MBC) is rare, accounting for less than 1% of all breast cancer but the incidence has increased worldwide. Risk factors include increased longevity, obesity, testicular diseases and tumours, and germline mutations of BRCA2. BRCA2 carriers have 80 times the risk of the general population. Men generally present with breast cancer at an older age compared with women. Histologically, MBC is often of grade 2, hormone receptor positive, HER2 negative, and no special type carcinoma although in situ and invasive papillary carcinomas are common. Reporting and staging are similar to female breast cancer. Metastatic lesions to the male breast do occur and should be differentiated from primary carcinomas. Until recently, MBC was thought to be similar to the usual ER positive post-menopausal female counterpart. However, advances in MBC research and trials have highlighted significant differences between the two. This review provides an up to date overview of the biology, genetics, and histology of MBC with comparison to female breast cancers and differential diagnosis from histological mimics.
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Kamel MG, El-Qushayri AE, Sayed AK, Huy NT. Using the primary site as a prognostic tool for nodal mantle cell lymphoma: a SEER-based study. J Comp Eff Res 2020; 9:861-876. [PMID: 32885984 DOI: 10.2217/cer-2020-0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Nodal mantle cell lymphoma (NMCL) has a worse survival than extra-nodal mantle cell lymphoma. Materials & methods: A cohort study was conducted to evaluate the primary site role as a mortality predictor using data from 1983 to 2011 from the Surveillance, Epidemiology, and End Results (SEER) database. Results: Most patients had NMCL in multiple regions (71.9%). There was a significantly increased incidence of NMCL cases over years with 83.2% of them occurred between 1998 and 2011. The mean survival was 52.9 months with overall survival/cancer-specific survival rate of 29.2/42.9%, respectively. Lymph nodes of intrathoracic and multiple regions had a worse overall survival while the head, face and neck, intra-abdominal, pelvic, inguinal region and leg as well as multiple regions had worse cancer-specific survival. Conclusion: NMCL primary site can serve as a prognostic factor. We encourage adding it to MCL International Prognostic Index.
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Affiliation(s)
| | | | | | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City 70000, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City 70000, Vietnam
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Zhou X, Wu C, Cheng Q. Negative Lymph Node Count Predicts Survival of Resected Non-small Cell Lung Cancer. Lung 2020; 198:839-846. [PMID: 32683563 DOI: 10.1007/s00408-020-00378-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/03/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to explore the association between the negative lymph node (NLN) count and survival, as well as compare the prognostic value of the positive lymph node (PLN) count, lymph node ratio (the PLN count/total lymph nodes examined, LNR), and NLN count in patients with non-small cell lung cancer (NSCLC). METHODS We identified patients diagnosed with NSCLC between 2005 and 2011 from the Surveillance, Epidemiology, and End Results database. Outcomes of interest were lung cancer-specific survival (LCSS) and overall survival (OS). Cases were divided into several groups based on the PLN count, NLN count, and LNR. The prognostic significance of the PLN count, NLN count, and LNR models was analyzed with the Kaplan-Meier method and the Cox regression model. RESULTS 39,959 patients with surgical resection for NSCLC were identified. Univariate analysis demonstrated that a greater count of NLNs was associated with better LCSS (P < 0.001) and OS (P < 0.001). Subgroup analysis showed that the NLN count could predict survival in both node-negative and node-positive patients. Multivariable analysis revealed that the NLN count was an independent prognostic factor for LCSS and OS. CONCLUSION The NLN count is an independent prognostic factor of OS and LCSS in patients with NSCLC, as well as the PLN count and LNR. The prognostic value of the PLN count, NLN count, and LNR shows no difference.
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Affiliation(s)
- Xinyan Zhou
- School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai, 200025, China
| | - Chunxiao Wu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai Institutes of Preventive Medicine, 1380 Zhongshan West Road, Shanghai, 200336, China
| | - Qi Cheng
- School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai, 200025, China.
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Huszno J, Kołosza Z, Mrochem-Kwarciak J, Zajusz A. Prognostic Value of the Neutrophil-Lymphocyte, Platelet-Lymphocyte, and Monocyte-Lymphocyte Ratios in Male Breast Cancer Patients. Oncology 2020; 98:487-492. [PMID: 32344419 DOI: 10.1159/000505627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 11/14/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of the present study was to assess the blood neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) as prognostic factors in male breast cancer (BC) patients. METHODS A retrospective analysis of 38 male BC patients who were treated at the Institute of Oncology (Gliwice, Poland) between January 2005 and December 2018 was performed. The prognostic value (in terms of overall survival [OS]) of the pretreatment PLR, NLR, and MLR was assessed by univariate analysis. RESULTS We observed a tendency towards worse OS among male BC patients with lymph node metastases (N+) (5-year OS: 43.5 vs. 73.9%; p = 0.087), a greater tumor size (T4 vs. T1 + T2) (42.0 vs. 70.5%; p = 0.061), and a negative steroid receptor status (PR-) (28.6 vs. 65.6%; p = 0.109). Patients with a family history of cancer had significantly better 5-year OS than patients without a family history of cancer (86.3 vs. 35.0%; p = 0.001). Younger male BC patients (age ≤56 years) had better 5-year OS than patients >56 years of age (82.5 vs. 42.3%; p = 0.028). The 5-year OS was lower among patients with a lower lymphocyte value (≤1.82 × 103) (29.0 vs. 75.6%; p = 0.010). There was a tendency towards worse OS among patients with a higher platelet count (>281 × 103) (4.5-year OS: 16.7 vs. 65.8%; p = 0.056). The 5-year OS was insignificantly lower in the group with NLRs >2.74 than in the group with NLRs ≤2.74 (37.5 vs. 62.8%; p = 0.078). A worse OS rate was associated with an elevated PLR (>169.1) (22.2 vs. 70.1%; p = 0.008). Similarly, there was worse OS in the group with higher MLR (>0.30) (41.8 vs. 78.3%; p = 0.025). CONCLUSIONS The present results reveal that elevated MLRs (>0.30) and PLRs (>169.1) are associated with poor OS among male BC patients. Similarly, but insignificantly, an elevated NLR (>2.74) affected OS.
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Affiliation(s)
- Joanna Huszno
- Genetic Outpatient Clinic, National Research Institute of Oncology, Gliwice, Poland,
| | - Zofia Kołosza
- Department of Biostatistics and Bioinformatics, National Research Institute of Oncology, Gliwice, Poland
| | - Jolanta Mrochem-Kwarciak
- Analytics and Clinical Biochemistry Department, National Research Institute of Oncology, Gliwice, Poland
| | - Aleksander Zajusz
- Outpatient Clinic, National Research Institute of Oncology, Gliwice, Poland
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