Personalized four-category staging for predicting prognosis in patients with small bowel Adenocarcinoma : an international development and validation study

Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved..

BACKGROUND: Log odds of positive lymph nodes (LODDS) classification showed superiority over 8th edition N staging in predicting survival of small bowel adenocarcinoma (SBA) patients. The aim of this study was to develop and validate the Tumor, LODDS, and Metastasis (TLM) staging of SBA.

METHODS: Totally 1789 SBA patients from the Surveillance, Epidemiology, and End Results (SEER) database between 1988-2010, 437 patients from SEER database between 2011-2013 and 166 patients from multicenters were categorized into development, validation and test cohort, respectively. The TLM staging was developed in the development cohort using Ensemble Algorithm for Clustering Cancer Data (EACCD) method. C-index was used to assess the performance of the TLM staging in predicting cancer-specific survival (CSS) and was compared with the traditional 8th edition TNM staging.

FINDINGS: Four-category TLM staging designed for the development cohort showed higher discriminatory power than TNM staging in predicting CSS in the development cohort (0.682 vs. 0.650, P < 0.001), validation cohort (0.682 vs. 0.654, P = 0.022), and test cohort (0.659 vs. 0.611, P = 0.023), respectively. TLM staging continued to show its higher predictive efficacy than the 8th TNM in TNM stage II/III patients or in patients with lymph node yield less than 8.

INTERPRETATION: TLM staging showed a better prognostic performance than the 8th TNM staging especially TNM stage II/III or patients with lymph node yield less than 8 and therefore, could serve to complement the TNM staging in patients with SBA.

FUNDING: A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:60

Enthalten in:

EBioMedicine - 60(2020) vom: 01. Okt., Seite 102979

Sprache:

Englisch

Beteiligte Personen:

Dai, Zi-Hao [VerfasserIn]
Wang, Qi-Wen [VerfasserIn]
Zhang, Qing-Wei [VerfasserIn]
Yan, Xia-Lin [VerfasserIn]
Aparicio, Thomas [VerfasserIn]
Zhou, Yang-Yang [VerfasserIn]
Wang, Huan [VerfasserIn]
Zhang, Chi-Hao [VerfasserIn]
Zaanan, Aziz [VerfasserIn]
Afchain, Pauline [VerfasserIn]
Zhang, Yan [VerfasserIn]
Chen, Hui-Min [VerfasserIn]
Gao, Yun-Jie [VerfasserIn]
Ge, Zhi-Zheng [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Prediction
Prognosis
Small bowel adenocarcinoma
TLM stage
TNM stage

Anmerkungen:

Date Completed 19.07.2021

Date Revised 19.07.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.ebiom.2020.102979

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM315514108