Impacto pronóstico del Log Odds de ganglios linfáticos positivos (LODDS) en la estratificación de pacientes con cáncer de recto

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola Pub Date : 2024-12-01 DOI:10.1016/j.ciresp.2024.09.006

Vincenzo Vigorita , Oscar Cano-Valderrama , Raquel Sánchez-Santos , Marta Paniagua-Garcia-Señorans , Enrique Moncada , Gianluca Pellino , Jesús Paredes-Cotoré , Enrique Casal

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Abstract

Introduction

The use of the N category of the TNM staging system, lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) in predicting overall survival (OS) and disease-free survival (DFS) in patients with rectal cancer is still controversial.

Material and methods

A retrospective study of 445 patients with rectal cancer who underwent surgery between 2008 and 2017 in the University Complex Hospital of Vigo was performed. Patients were stratified according to number of lymph nodes examined (NLNE), N staging, LNR and LODDS. The analysis was performed using the log-rank test, Kaplan-Meier functions, Cox regression and ROC curves.

Results

Five-year OS and DFS were 73.7% and 62.5%, respectively. No statistically significant differences were observed depending on NLNE. Increased LNR and LODDS were associated with shorter OS and DFS, independently of NLNE.

Multivariate analysis showed that N stage, LNR and LODDS were independently associated with OS and DFS; however, the LODDS system obtained the best area under the curve, with greater predictive capacity for OS (AUC: 0.679) and DFS (AUC: 0.711).

Conclusion

LODDS and LNR give prognostic information that is not related to NLNE. LODDS provides better prognostic accuracy in patients with negative nodes than LNR and N stage.

Abstract Image

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淋巴结阳性Log Odds （LODDS）对直肠癌患者分层的预测影响

TNM分期系统的N类、淋巴结比（LNR）和阳性淋巴结对数赔率（LODDS）在预测直肠癌患者总生存期（OS）和无病生存期（DFS）中的应用仍存在争议。材料与方法对2008年至2017年在维戈大学综合医院接受手术治疗的445例直肠癌患者进行回顾性研究。根据检查淋巴结数（NLNE）、N分期、LNR和LODDS对患者进行分层。采用log-rank检验、Kaplan-Meier函数、Cox回归和ROC曲线进行分析。结果5年OS和DFS分别为73.7%和62.5%。不同NLNE的差异无统计学意义。LNR和LODDS的增加与较短的OS和DFS相关，与NLNE无关。多因素分析显示，N分期、LNR、LODDS与OS、DFS独立相关；而LODDS系统曲线下面积最佳，对OS （AUC: 0.679）和DFS （AUC: 0.711）的预测能力更强。结论lodds和LNR可提供与NLNE无关的预后信息。LODDS在阴性淋巴结患者的预后准确性优于LNR和N期。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cirugia Espanola SURGERY-

CiteScore

1.20

自引率

21.10%

发文量

173

审稿时长

53 days

期刊介绍： Cirugía Española, an official body of the Asociación Española de Cirujanos (Spanish Association of Surgeons), will consider original articles, reviews, editorials, special articles, scientific letters, letters to the editor, and medical images for publication; all of these will be submitted to an anonymous external peer review process. There is also the possibility of accepting book reviews of recent publications related to General and Digestive Surgery.