Published in:
01-06-2008 | Gastrointestinal Oncology
A Common Misuse of Stepwise Regression in Studies of Ratio of Metastatic Lymph Nodes for Gastric Cancer
Authors:
Xi Wang, MD, Fei Wan, MS, Jie-Jun Wang, MD, PhD
Published in:
Annals of Surgical Oncology
|
Issue 6/2008
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Excerpt
It is well demonstrated that lymph node metastasis is an important prognostic factor for gastric cancer.
1‐
3 However, the status of lymph nodes is evaluated by several different N classifications, and there is no consensus for gastric cancer. In the pN classification, proposed by the International Union Against Cancer (UICC) in the Fifth TNM staging system, the lymph node status was classified according to the number of involved lymph nodes irrespective of their site.
4 By contrast, in the Japanese Classification, proposed by the Japanese Gastric Cancer Association (JGCA), the status of lymph node was divided according to their anatomical distribution, irrespective of their number.
5 In addition, the ratio of metastatic lymph node (RML), that is, the number of metastatic lymph nodes/number of retrieved lymph nodes, is also a useful N classification for gastric cancer.
6 Because of possible simplicity, quantitativity, reliability, reproducibility, and potential advantage of avoiding the “stage migration” phenomenon,
7,
8 the RML classification has been closely investigated in recent years. To our knowledge, the RML has been brought into more than 40 published articles as a possible prognostic factor. Moreover, a few of studies have identified the RML classification as an independent prognostic factor
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16 and attempted to argue that it would be a potential new staging system for gastric cancer.
13 …
