Modified Nodal Stage of esophageal cancer based on the evaluation of the hazard rate of the negative and positive lymph node [post]

Jinling Zhang, Hongyan Li, Liangjian Zhou, Lianling Yu, Fengyuan Che, Xueyuan Heng
2020 unpublished
Objective:The study aimed to propose a modified Nodal stage of esophageal cancer (EC) on basis of the number of positive lymph node (PLN) and the number of negative lymph node (NLN) simultaneously.Method:Data from 13,491 patients with EC registered in the SEER database were reviewed. The parameters related to prognosis were investigated using a Cox proportional hazards regression model. A modified N stage was proposed based on the cut-off number of the re-adjusted ratio of the number of PLN
more » ... berPLN) to the number of NLN (numberNLN), which were derived from the comparison of the hazard rate (HR) of numberPLN and numberNLN. The modified N stage was confirmed using the cross-validation method with the training and validation cohort, and it was also compared to the N stage from the American Joint Committee on Cancer (AJCC) staging system (7th edition) using Receiver Operating Characteristic (ROC) curve analysis.Results:The numberPLN on prognosis was 1.064, while numberNLN was 0.962. The modified N stage was defined as follows: N1 stage: the ratio range was from 0 to 0.08; N2 stage: more than 0.08, but no more than 0.63; N3 stage: more than 0.63. Cross-validation method within the cohort identified the predictive accuracy of this modified N stage, and ROC curve analysis demonstrated the relative superiority of the modified N stage over that of the AJCC N stage.Conclusion:The modified N stage based on the re-adjusted ratio of numberPLN to numberNLN can evaluate tumor stage relative accurately than the traditional N stage.
doi:10.21203/rs.3.rs-54021/v1 fatcat:gtsjsp5eanhthfxmmqvnerterq