KEY TAKEAWAYS
- The study aimed to assess the prognostic value of the LODDS in staging GEC post-neoadjuvant chemoradiation.
- Researchers found that TLODDSM better predicts prognosis and guides adjuvant therapy for patients with GEC post-neoadjuvant chemoradiation.
After neoadjuvant chemoradiation, the number of examined lymph nodes in resectable gastroesophageal cancer (GEC) often decreases, potentially compromising the accuracy of N staging.
Shuang Liu and the team aimed to evaluate the clinical relevance of a novel staging model based on the logarithmic odds of positive lymph nodes (LODDS) for patients with GEC who have undergone neoadjuvant chemoradiation.
They performed an inclusive analysis involving 1,130 patients with pathologically diagnosed GEC who received neoadjuvant chemoradiation between 2004 and 2019, sourced from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database. Lymph nodes were staged using both the AJCC TNM staging system (eighth edition) and the LODDS model.
Patient prognosis was assessed with the Kaplan-Meier method, and differences in node staging were evaluated using the Akaike Information Criterion and Bayesian Information Criterion. Additionally, 914 patients from the researchers’ center were used for external validation of the findings.
In comparison with the traditional TNM staging system, the new TLODDSM staging system, which includes stages I, II, IIIA, IIIB, and IVA, demonstrated higher benefits at various decision thresholds according to decision curve analysis.
The Akaike Information Criterion and Bayesian Information Criterion for the TLODDSM staging system were lower than those for the traditional TNM system, indicating improved sensitivity in predicting patient prognosis.
Additionally, patients classified as stage IIIB or IVA in the new system showed significant benefit from adjuvant chemotherapy. These findings were corroborated by externally validated data from the center.
The study concluded that the TLODDSM staging system offers significant advantages over the TNM staging system in predicting prognosis for patients with GEC who have completed neoadjuvant chemoradiation. This new system provides better guidance for adjuvant chemotherapy decisions, enhancing patient management and treatment outcomes.
The study was funded by the Department of Science and Technology of Jilin Province (No YDZJ202201ZYTS668).
Source: https://pubmed.ncbi.nlm.nih.gov/39210382/
Liu S, Wang Z, Ge Y, et al. (2024). “Prognostic significance of an innovative staging system based on the logarithmic odds of positive lymph nodes for resectable gastroesophageal cancer after neoadjuvant chemoradiation: a population-based study with external validation of data.” J Transl Med. 2024;22(1):801. Published 2024 Aug 29. doi:10.1186/s12967-024-05448-5
