Lymph node status after resection for gallbladder adenocarcinoma: Prognostic implications of different nodal staging/scoring systems. Issue 3 (13th October 2014)

• Record Type: Journal Article
• Authors: Amini, Neda; Spolverato, Gaya; Kim, Yuhree; Gupta, Rohan; Margonis, Georgios Antonios; Ejaz, Aslam; Pawlik, Timothy M.
• Is Part Of: Journal of surgical oncology. Volume 111:Issue 3(2015:Mar. 01)
• Page Start: 299
• Page End: 305
• Publication Date: 2014-10-13
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23813
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso23813-sec-0001" sec-type="section"> <title>Background and Objectives</title> <p>Several lymph node (LN) staging/scoring systems have been proposed to stratify the prognosis of patients with gallbladder adenocarcinoma (GBA). We sought to define the prognostic performance of the most commonly utilized LN staging/scoring systems including AJCC/UICC N stage, lymph node ratio (LNR), log odds (LODDS), and N score, among patients with GBA.</p> </sec> <sec id="jso23813-sec-0002" sec-type="section"> <title>Method</title> <p>Between 2004 and 2010, 1, 124 patients with GBA were identified from the Surveillance Epidemiology and End Results (SEER) database. The discriminative ability of each LN staging/scoring system was assessed using the Akaike's Information Criterion (AIC) and the Harrell's concordance index.</p> </sec> <sec id="jso23813-sec-0003" sec-type="section"> <title>Results</title> <p>When assessed using categorical values, LNR had a modest, improved ability to discriminate patients with regard to prognosis (C‐index: 0.615; AIC: 2118.2) compared with AJCC/UICC N stage or N score and a prognostic discrimination comparable to LODDS. Among patients who had a total number of LN examined (TNLE) of 1 or 2, all the staging/scoring systems performed comparably. In contrast, among patients who had ≥4 TNLE, LODDS performed the best (C‐index: 0.613; AIC: 303.2).</p> </sec> <sec id="jso23813-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The performance of the different LN staging/scoring systems varied based on the TNLE. In particular, for patients who had ≥4 TNLE, LODDS out‐performed the other staging/scoring systems. <italic>J. Surg. Oncol. 2015 111:299–305</italic>. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>