Evaluating the prognostic significance of tumor deposits in gastric cancer and strategies for their integration into the TNM staging system: a single-center retrospective study.

IF 6.6 2区 医学 Q1 Medicine
Cellular Oncology Pub Date : 2025-06-01 Epub Date: 2025-02-17 DOI:10.1007/s13402-025-01046-9
Jun Yu, Ruirong Yao, Ning Han, Linbin Lu, Ling Chen, Abudurousuli Reyila, Xinlin Wang, Junya Yan, Shibo Wang, Yong Guo, Qingchuan Zhao, Kaichun Wu, Yuanyuan Lu, Gang Ji, Zengshan Li, Xianchun Gao, Yongzhan Nie
{"title":"Evaluating the prognostic significance of tumor deposits in gastric cancer and strategies for their integration into the TNM staging system: a single-center retrospective study.","authors":"Jun Yu, Ruirong Yao, Ning Han, Linbin Lu, Ling Chen, Abudurousuli Reyila, Xinlin Wang, Junya Yan, Shibo Wang, Yong Guo, Qingchuan Zhao, Kaichun Wu, Yuanyuan Lu, Gang Ji, Zengshan Li, Xianchun Gao, Yongzhan Nie","doi":"10.1007/s13402-025-01046-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To propose a new optimal strategy for incorporating tumor deposit (TD) into TNM staging.</p><p><strong>Methods: </strong>Totally, 2730 consecutive gastric cancer (GC) patients were included according to the presence and count of TDs between January 2011 and December 2014. Overall survival (OS) was analyzed using Cox regression and propensity score matching (PSM). The relationship between the number of TDs and GC patients' prognosis was analyzed using restricted cubic spline curves and compared with the prognostic value of lymph node metastases (LNMs). Harrell's C-index (C-index) and the Akaike information criterion (AIC) were employed to assess the prognostic performance of different staging systems.</p><p><strong>Results: </strong>The positive rate of TD was 9.67% (264/2730). The presence of TD was associated with poorer OS before PSM (hazard ratio (HR): 3.31; 95% confidence interval (CI): 2.84, 3.85) and after PSM (HR: 1.62; 95%CI: 1.31, 2.00). The modified TNM staging, equating one TD to four LNMs, achieved superior prognostic performance, surpassing the 8th edition AJCC TNM staging and other modified systems (C-index: 0.751, AIC: 15954.0). In this system, 12.04% (26/216) of TD-positive patients were upstaged from stage II to stage III. These upstaged patients had worse outcomes than the remaining stage II patients (HR: 10.97; 95% CI: 4.55-26.44), while outcomes were similar to those of original stage III patients (HR:1.08; 95%CI: 0.66, 1.78).</p><p><strong>Conclusion: </strong>The presence and increased number of TDs were noted to be associated with GC patients' poor prognosis. Integrating TD count with LNMs could enhance the prognostic accuracy of the TNM staging system.</p>","PeriodicalId":9690,"journal":{"name":"Cellular Oncology","volume":" ","pages":"761-773"},"PeriodicalIF":6.6000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119653/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cellular Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13402-025-01046-9","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/17 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: To propose a new optimal strategy for incorporating tumor deposit (TD) into TNM staging.

Methods: Totally, 2730 consecutive gastric cancer (GC) patients were included according to the presence and count of TDs between January 2011 and December 2014. Overall survival (OS) was analyzed using Cox regression and propensity score matching (PSM). The relationship between the number of TDs and GC patients' prognosis was analyzed using restricted cubic spline curves and compared with the prognostic value of lymph node metastases (LNMs). Harrell's C-index (C-index) and the Akaike information criterion (AIC) were employed to assess the prognostic performance of different staging systems.

Results: The positive rate of TD was 9.67% (264/2730). The presence of TD was associated with poorer OS before PSM (hazard ratio (HR): 3.31; 95% confidence interval (CI): 2.84, 3.85) and after PSM (HR: 1.62; 95%CI: 1.31, 2.00). The modified TNM staging, equating one TD to four LNMs, achieved superior prognostic performance, surpassing the 8th edition AJCC TNM staging and other modified systems (C-index: 0.751, AIC: 15954.0). In this system, 12.04% (26/216) of TD-positive patients were upstaged from stage II to stage III. These upstaged patients had worse outcomes than the remaining stage II patients (HR: 10.97; 95% CI: 4.55-26.44), while outcomes were similar to those of original stage III patients (HR:1.08; 95%CI: 0.66, 1.78).

Conclusion: The presence and increased number of TDs were noted to be associated with GC patients' poor prognosis. Integrating TD count with LNMs could enhance the prognostic accuracy of the TNM staging system.

评估胃癌肿瘤沉积物的预后意义及其纳入TNM分期系统的策略:一项单中心回顾性研究
目的:提出一种新的将肿瘤沉积(TD)纳入TNM分期的最佳策略。方法:2011年1月至2014年12月,根据TDs的存在及计数纳入2730例连续胃癌患者。采用Cox回归和倾向评分匹配(PSM)分析总生存期(OS)。采用限制性三次样条曲线分析TDs数量与胃癌患者预后的关系,并与淋巴结转移(LNMs)的预后价值进行比较。采用Harrell's C-index (C-index)和赤池信息标准(Akaike information criterion, AIC)评价不同分期系统的预后。结果:TD阳性率为9.67%(264/2730)。TD的存在与PSM前较差的OS相关(风险比(HR): 3.31;95%置信区间(CI): 2.84, 3.85)和PSM后(HR: 1.62;95%ci: 1.31, 2.00)。改进的TNM分期,相当于1个TD = 4个lnm,取得了更好的预后表现,超过了第8版AJCC TNM分期和其他改进的系统(c指数:0.751,AIC: 15954.0)。在该系统中,12.04%(26/216)的td阳性患者从II期被抢到了III期。这些被抢风头的患者的预后比其他II期患者更差(HR: 10.97;95% CI: 4.55-26.44),而结果与原始III期患者相似(HR:1.08;95%ci: 0.66, 1.78)。结论:TDs的存在及数量增加与胃癌患者预后不良有关。将TNM与TD计数相结合可提高TNM分期系统的预后准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Cellular Oncology
Cellular Oncology Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
10.40
自引率
1.50%
发文量
0
审稿时长
16 weeks
期刊介绍: The Official Journal of the International Society for Cellular Oncology Focuses on translational research Addresses the conversion of cell biology to clinical applications Cellular Oncology publishes scientific contributions from various biomedical and clinical disciplines involved in basic and translational cancer research on the cell and tissue level, technical and bioinformatics developments in this area, and clinical applications. This includes a variety of fields like genome technology, micro-arrays and other high-throughput techniques, genomic instability, SNP, DNA methylation, signaling pathways, DNA organization, (sub)microscopic imaging, proteomics, bioinformatics, functional effects of genomics, drug design and development, molecular diagnostics and targeted cancer therapies, genotype-phenotype interactions. A major goal is to translate the latest developments in these fields from the research laboratory into routine patient management. To this end Cellular Oncology forms a platform of scientific information exchange between molecular biologists and geneticists, technical developers, pathologists, (medical) oncologists and other clinicians involved in the management of cancer patients. In vitro studies are preferentially supported by validations in tumor tissue with clinicopathological associations.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信