Abstract
BackgroundVarious factors may affect the clinical prognosis of lymph node-negative gastric cancer (GC) patients. This study aimed to provide evaluable prognostic information of combination of tumor size (Ts), lymph nodes count (LNs) and lymphovascular invasion (LVI) in lymph node-negative GC patients.MethodsA total of 1,019 node-negative GC patients were enrolled in this retrospective study from 2000 to 2010. The cutoff points of Ts and LNs were determined using X-tile and patients were randomly categorized into training and validation sets by the sample size ratio 1:1. The clinicopathologic characteristics were analyzed and survival prognostic factors were identified, whereas the survival prediction accuracy was also compared by C-index during the different independent prognostic factors.ResultsThe cutoff points for Ts were 3cm and 5cm, while 14 was the cutoff point for LNs. Age, T stage, Ts, LNs and LVI were identified as independent prognostic factors in node-negative GC patients, and a new prognostic predictive model, TsNL staging system which was composed of Ts, LNs and LVI, was proposed in this study. Compared with T staging system, significant improvement of predictive accuracy for TsNL system was found. Furthermore, nomogram based on TsNL was more accurate in prognostic prediction than that based on Ts, LNs and LVI, separately.ConclusionsAge, T stage, Ts, LNs and LVI were independent prognostic factors in lymph node-negative GC patients. The TsNL staging system, composed of Ts, LNs and LVI, which was closely associated with clinicopathologic features, may improve the prognostic prediction accuracy in node-negative GC patients.
Highlights
Despite declining global incidence, gastric cancer (GC) remains one of the most common malignances nowadays, with the secondary leading cause of cancerrelated mortality in China [1]
Lymph nodenegative GC patients have been demonstrated in previous studies [4, 5] to present better survival than those with positive lymph nodes involvement, even among the node-negative patients, the survival rate for certain subgroups were worse than others, and some of them still were at the risk of recurrence or cancer-related death
Several investigators reported that, apart from the most important prognostic factor, T stage, various clinicopathologic factors such as lymphovascular invasion (LVI) [6,7,8,9], tumor size (Ts) [4, 10, 11], lymph node count (LNs) [12,13,14,15] and perineural invasion [16], were confirmed as independent prognostic factors which were significantly associated with survival for node-negative GC patients followed curative resection, no consensus on this issue by far has been yet reached and few studies focused on prognostic role of the combination of these prognostic factors [6]
Summary
Gastric cancer (GC) remains one of the most common malignances nowadays, with the secondary leading cause of cancerrelated mortality in China [1]. Several investigators reported that, apart from the most important prognostic factor, T stage, various clinicopathologic factors such as lymphovascular invasion (LVI) [6,7,8,9], tumor size (Ts) [4, 10, 11], lymph node count (LNs) [12,13,14,15] and perineural invasion [16], were confirmed as independent prognostic factors which were significantly associated with survival for node-negative GC patients followed curative resection, no consensus on this issue by far has been yet reached and few studies focused on prognostic role of the combination of these prognostic factors [6]. This study aimed to provide evaluable prognostic information of combination of tumor size (Ts), lymph nodes count (LNs) and lymphovascular invasion (LVI) in lymph node-negative GC patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
