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A Nomogram for Predicting Overall Survival of Gastric Cancer Patients with Insufficient Lymph Nodes Examined

  • Original Article
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Journal of Gastrointestinal Surgery

Abstract

Insufficient number of examined lymph nodes (eLNs) was considered to increase significantly the risk of stage migration in gastric cancer patients. The aim of our study is to establish a nomogram predicting the overall survival (OS) for patients with an insufficient number of eLNs. A total of 872 gastric cancer patients with extended lymphadenectomies were assigned randomly (2:1) to the development cohort and the validation cohort. The nomogram was established based on the Cox regression model using the development cohort. The concordance index (C-index) was used to evaluate the discriminative ability. We also compared our model with two other staging systems. Using multivariate analysis, age, sex, tumor location, depth of invasion, macroscopic type, lymphovascular invasion, the number of eLNs, and metastatic lymph nodes were selected and incorporated into the nomogram. The C-index of the nomogram was 0.742 and 0.743 in development and validation cohorts, respectively, which were significantly superior to the C-indices (range 0.705–0.712, all P < 0.001) of American Joint Committee on Cancer (AJCC) seventh edition and lymph node ratio staging systems in both cohorts. We established a nomogram which could predict accurately OS for gastric cancer patients with insufficient number of eLNs.

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Authors and Affiliations

  1. Department of Surgical Oncology, The First Affiliated Hospital of China Medical University, 155 Nan**g North Street, He** District, Shenyang, 110001, China

    Peng-liang Wang MD, Fang-tao **ao MD, Bao-cheng Gong MD, Fu-nan Liu MD, PhD & Hui-mian Xu MD, PhD

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  1. Peng-liang Wang MD
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  2. Fang-tao **ao MD
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  3. Bao-cheng Gong MD
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  4. Fu-nan Liu MD, PhD
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  5. Hui-mian Xu MD, PhD
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Contributions

Research idea and study design: LFN, XHM, and WPL; data analysis/interpretation: WPL, XFT, and GBC; statistical analysis: WPL and LFN; supervision or mentorship: LFN and XHM. All the authors contributed important intellectual content for the overall work. LFN and XHM take responsibility for the honesty and accuracy of the present study.

Corresponding authors

Correspondence to Fu-nan Liu MD, PhD or Hui-mian Xu MD, PhD.

Ethics declarations

This study was approved by the Institutional Ethics Committee of China Medical University.

Grant Support

This work was supported by the National Natural Science Foundation of China (No. 81001092) and the Natural Science Foundation of Liaoning Province of China (No. 2013021097).

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Wang, Pl., **ao, Ft., Gong, Bc. et al. A Nomogram for Predicting Overall Survival of Gastric Cancer Patients with Insufficient Lymph Nodes Examined. J Gastrointest Surg 21, 947–956 (2017). https://doi.org/10.1007/s11605-017-3401-6

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