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01-08-2019 | Gallbladder Cancer | Original Article

Validation of the prognostic performance in various nodal staging systems for gallbladder cancer: results of a multicenter study

Authors: Woohyung Lee, Chi-Young Jeong, Young Hoon Kim, Young Hoon Roh, Myung Hee Yoon, Hyung Il Seo, Jeong-Ik Park, Bo-Hyun Jung, Dong Hoon Shin, Young Il Choi, Je Ho Ryu, Kwang Ho Yang, Chang Soo Choi, Yo-Han Park, Yang Won Nah, Soon-Chan Hong

Published in: Langenbeck's Archives of Surgery | Issue 5/2019

Abstract

Background

Although the current nodal staging system for gallbladder cancer (GBC) was changed based on the number of positive lymph nodes (PLN), it needs to be evaluated in various situations.

Methods

We reviewed the clinical data for 398 patients with resected GBC and compared nodal staging systems based on the number of PLNs, the positive/retrieved LN ratio (LNR), and the log odds of positive LN (LODDS). Prognostic performance was evaluated using the C-index.

Results

Subgroups were formed on the basis of an restricted cubic spline plot as follows: PLN 3 (PLN = 0, 1–2, ≥ 3); PLN 4 (PLN = 0, 1–3, ≥ 4); LNR (LNR = 0, 0–0.269, ≥ 0.27); and LODDS (LODDS < − 0.8, − 0.8–0, ≥ 0). The oncological outcome differed significantly between subgroups in each system. In all patients with GBC, PLN 4 (C-index 0.730) and PLN 3 (C-index 0.734) were the best prognostic discriminators of survival and recurrence, respectively. However, for retrieved LN (RLN) ≥ 6, LODDS was the best discriminator for survival (C-index 0.852).

Conclusion

The nodal staging system based on PLN was the optimal prognostic discriminator in patients with RLN < 6, whereas the LODDS system is adequate for RLN ≥ 6. The following nodal staging system considers applying different systems according to the RLN.

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Title: Validation of the prognostic performance in various nodal staging systems for gallbladder cancer: results of a multicenter study
Authors: Woohyung Lee
Chi-Young Jeong
Young Hoon Kim
Young Hoon Roh
Myung Hee Yoon
Hyung Il Seo
Jeong-Ik Park
Bo-Hyun Jung
Dong Hoon Shin
Young Il Choi
Je Ho Ryu
Kwang Ho Yang
Chang Soo Choi
Yo-Han Park
Yang Won Nah
Soon-Chan Hong
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Gallbladder Cancer
Gallbladder Cancer
Published in: Langenbeck's Archives of Surgery / Issue 5/2019
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-019-01807-9

At a glance: The STEP trials

Springer Medicine

Validation of the prognostic performance in various nodal staging systems for gallbladder cancer: results of a multicenter study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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