典型文献
Standardizing the classification of gastric cancer patients with limited and adequate number of retrieved lymph nodes: an externally validated approach using real?world data
文献摘要：
Background: Currently, there is no formal consensus regarding a standard classification for gastric cancer (GC) patients with <16 retrieved lymph nodes (rLNs). Here, this study aimed to validate a practical lymph node (LN) staging strategy to homogenize the nodal classification of GC cohorts comprising of both <16 (Limited set) and ≥16 (Adequate set) rLNs.Methods: All patients in this study underwent R0 gastrectomy. The overall survival (OS) difference between the Limited and Adequate sets from a large Chinese multicenter dataset was analyzed. Using the 8th American Joint Committee on Cancer (AJCC) pathological nodal classification (pN) for GC as base, a modified nodal classification (N') resembling similar analogy as the 8th AJCC pN classification was developed. The performance of the proposed and 8th AJCC GC subgroups was compared and validated using the Surveillance, Epidemiology, and End Results (SEER) dataset comprising of 10,208 multi-ethnic GC cases. Results: Significant difference in OS between the Limited and Adequate sets (corresponding N0–N3a) using the 8th AJCC system was observed but the OS of N0limited vs. N1adequate, N1limited vs. N2adequate, N2limited vs. N3aadequate, and N3alimited vs. N3badequate subgroups was almost similar in the Chinese dataset. Therefore, we formulated an N' classification whereby only the nodal subgroups of the Limited set, except for pT1N0M0 cases as they underwent less extensive surgeries (D1 or D1 + gastrectomy), were re-classified to one higher nodal subgroup, while those of the Adequate set remained unchanged (N'0=N0adequate+pT1N0M0limited, N'1=N1adequate+N0limited (excluding pT1N0M0limited), N'2=N2adequate+N1limited, N'3a=N3aadequate+N2limited, and N'3b=N3badequate+N3alimited). This N' classification demonstrated less heterogeneity in OS between the Limited and Adequate subgroups. Further analyses demonstrated superior statistical performance of the pTN'M system over the 8th AJCC edition and was successfully validated using the SEER dataset. Conclusions: The proposed nodal staging strategy was successfully validated in large multi-ethnic GC datasets and represents a practical approach for homogenizing the classification of GC cohorts comprising of patients with <16 and ≥16 rLNs.
文献关键词：
中图分类号：
作者姓名：
Wei Wang;Yu?Jie Yang;Ri?Hong Zhang;Jing?Yu Deng;Zhe Sun;Sharvesh Raj Seeruttun;Zhen?Ning Wang;Hui?Mian Xu;Han Liang;Zhi?Wei Zhou
作者机构：
Department of Gastric Surgery,Sun Yat?sen University Cancer Center,Guangzhou 510060,China;State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060,China;Department of Gastric Cancer Surgery,Tianjin Medical University Cancer Institute and Hospital,Tianjin 300000,China;Department of Surgical Oncology,the First Hospital of China Medical University,Shenyang 110000,China
文献出处：
引用格式：
[1]Wei Wang;Yu?Jie Yang;Ri?Hong Zhang;Jing?Yu Deng;Zhe Sun;Sharvesh Raj Seeruttun;Zhen?Ning Wang;Hui?Mian Xu;Han Liang;Zhi?Wei Zhou-.Standardizing the classification of gastric cancer patients with limited and adequate number of retrieved lymph nodes: an externally validated approach using real?world data)[J].军事医学研究（英文）,2022(05):565-575
A类：
Standardizing,rLNs,N0limited,N1adequate,N1limited,N2adequate,N2limited,N3aadequate,N3alimited,N3badequate,pT1N0M0,N0adequate+pT1N0M0limited,N1adequate+N0limited,pT1N0M0limited,N2adequate+N1limited,N3aadequate+N2limited,N3badequate+N3alimited,pTN,homogenizing
B类：
classification,gastric,cancer,patients,number,retrieved,lymph,nodes,externally,validated,approach,using,real,world,Background,Currently,there,formal,consensus,regarding,standard,Here,this,study,aimed,practical,staging,strategy,homogenize,nodal,cohorts,comprising,both,Limited,Adequate,Methods,All,underwent,R0,gastrectomy,overall,survival,OS,difference,between,from,large,Chinese,multicenter,was,analyzed,Using,8th,American,Joint,Committee,Cancer,AJCC,pathological,pN,base,modified,resembling,similar,analogy,developed,performance,proposed,subgroups,compared,Surveillance,Epidemiology,End,Results,SEER,ethnic,cases,Significant,corresponding,system,observed,but,almost,Therefore,formulated,whereby,only,except,they,less,extensive,surgeries,D1,were,classified,one,higher,while,those,remained,unchanged,excluding,This,demonstrated,heterogeneity,Further,analyses,superior,statistical,edition,successfully,Conclusions,datasets,represents
AB值：
0.369088
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