清晨好,您是今天最早来到科研通的研友!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您科研之路漫漫前行!

Nodal Status, Number of Lymph Nodes Examined, and Lymph Node Ratio: What Defines Prognosis after Resection of Colon Adenocarcinoma?

医学 淋巴 淋巴结 危险系数 结直肠癌 比例危险模型 肿瘤科 内科学 生存分析 腺癌 阶段(地层学) 癌症 病理 置信区间 古生物学 生物
作者
Ana Gleisner,Harveshp Mogal,Rebecca M. Dodson,Jon Efron,Susan L. Gearhart,Elizabeth Wick,Anne O. Lidor,Joseph M. Herman,Timothy M. Pawlik
出处
期刊:Journal of The American College of Surgeons [Lippincott Williams & Wilkins]
卷期号:217 (6): 1090-1100 被引量:64
标识
DOI:10.1016/j.jamcollsurg.2013.07.404
摘要

In Brief BACKGROUND: Lymph node ratio (LNR) has been proposed as an optimal staging variable for colorectal cancer. However, the interactive effect of total number of lymph nodes examined (TNLE) and the number of metastatic lymph nodes (NMLN) on survival has not been well characterized. STUDY DESIGN: Patients operated on for colon cancer between 1998 and 2007 were identified from the Surveillance, Epidemiology, and End Results database (n = 154,208) and randomly divided into development (75%) and validation (25%) datasets. The association of the TNLE and NMLN on survival was assessed using the Cox proportional hazards model with terms for interaction and nonlinearity with restricted cubic spline functions. Findings were confirmed in the validation dataset. RESULTS: Both TNLE and NMLN were nonlinearly associated with survival. Patients with no lymph node metastasis had a decrease in the risk of death for each lymph node examined up to approximately 25 lymph nodes, while the effect of TNLE was negligible after approximately 10 negative lymph nodes (NNLN) in those with lymph node metastasis. The hazard ratio varied considerably according to the TNLE for a given LNR when LNR ≥ 0.5, ranging from 2.88 to 7.16 in those with an LNR = 1. The independent effects of NMLN and NNLN on survival were summarized in a model-based score, the N score. When patients in the validation set were categorized according to the N stage, the LNR, and the N score, only the N score was unaffected by differences in the TNLE. CONCLUSIONS: The effect of the TNLE on survival does not have a unique, strong threshold (ie, 12 lymph nodes). The combined effect of NMLN and TNLE is complex and is not appropriately represented by the LNR. The N score may be an alternative to the N stage for prognostication of patients with colon cancer because it accounts for differences in nodal samples. The combined effect of total number of lymph nodes examined and the number of metastatic lymph nodes on survival after colon surgery for cancer is complex and not appropriately represented by the lymph node ratio.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
9秒前
量子星尘发布了新的文献求助10
12秒前
1分钟前
上官若男应助科研通管家采纳,获得20
1分钟前
过氧化氢应助科研通管家采纳,获得10
1分钟前
CUN完成签到,获得积分10
1分钟前
1分钟前
1分钟前
量子星尘发布了新的文献求助10
1分钟前
光合作用完成签到,获得积分10
1分钟前
2分钟前
清風折柳发布了新的文献求助10
2分钟前
2分钟前
zpc猪猪完成签到,获得积分10
2分钟前
小二郎应助清風折柳采纳,获得10
2分钟前
2分钟前
量子星尘发布了新的文献求助10
3分钟前
3分钟前
cadcae完成签到,获得积分10
3分钟前
TY完成签到 ,获得积分10
3分钟前
英俊的铭应助科研通管家采纳,获得10
3分钟前
yhgz完成签到,获得积分10
4分钟前
不秃燃的小老弟完成签到 ,获得积分10
4分钟前
文献搬运工完成签到 ,获得积分10
4分钟前
量子星尘发布了新的文献求助10
4分钟前
鲁卓林完成签到,获得积分10
4分钟前
yi完成签到 ,获得积分10
4分钟前
大模型应助科研通管家采纳,获得30
5分钟前
科研通AI2S应助科研通管家采纳,获得10
5分钟前
量子星尘发布了新的文献求助10
6分钟前
若水完成签到 ,获得积分10
6分钟前
6分钟前
喵喵完成签到 ,获得积分10
7分钟前
钱念波完成签到,获得积分10
7分钟前
量子星尘发布了新的文献求助10
8分钟前
8分钟前
Herbs完成签到 ,获得积分10
8分钟前
8分钟前
8分钟前
9分钟前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3976683
求助须知:如何正确求助?哪些是违规求助? 3520770
关于积分的说明 11204819
捐赠科研通 3257565
什么是DOI,文献DOI怎么找? 1798733
邀请新用户注册赠送积分活动 877897
科研通“疑难数据库(出版商)”最低求助积分说明 806629