Equipping the 8th Edition American Joint Committee on Cancer Staging for Gastric Cancer with the 15-Node Minimum: a Population-Based Study Using Recursive Partitioning Analysis
Bakcground The recently proposed 8th American Joint Committee on Cancer (AJCC) staging for gastric cancer (GC) did not include the evaluated lymph node (ELN) count as a prognostic indicator. In this study, we performed recursive partitioning analysis (RPA) to objectively combine the 15-ELN threshold...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2017-10, Vol.21 (10), p.1591-1598 |
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| creator | Yuan, Shu-Qiang Chen, Yu-Tong Huang, Ze-Ping |
| description | Bakcground
The recently proposed 8th American Joint Committee on Cancer (AJCC) staging for gastric cancer (GC) did not include the evaluated lymph node (ELN) count as a prognostic indicator. In this study, we performed recursive partitioning analysis (RPA) to objectively combine the 15-ELN threshold and 8th AJCC stage to refine the staging for GC.
Methods
We analyzed 19,018 patients with non-metastatic GC from the Surveillance, Epidemiology, and End Results database. The dataset was randomly divided into training and validation sets.
Results
For each 8th AJCC stage, survival was significantly better for patients with ≥15 ELNs versus those with |
| doi_str_mv | 10.1007/s11605-017-3504-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5610217</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1941922385</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-71e2b5635368a9e345d67300ae89ea104682c8c83613841f52b7b5a2832c0ac33</originalsourceid><addsrcrecordid>eNp1ks1uEzEUhUcIREvhAdggS2zYGPw742GBFKK0gApUQCV2luO5SVzN2KntKcpb9RHxkLYqSKxs-Xz33HvlU1XPKXlNCWneJEprIjGhDeaSCEweVIdUNRyLmtUPy520FDMpfx5UT1K6IAUkVD2uDphqJBOEHVbXi8vRbbfOr1HeAFJ5gxadyy54NBsgOms8-hScz2gehsHlDICKNjfeQkTfs1lPpasQ0YlJufC30i9XrCZLKvGX0AH67LwbxuEtMugsbMfeTE3we5OgKz5jt0PnafL6BnaMyV0BOjMx_xllep550--SS0-rRyvTJ3h2cx5V58eLH_MP-PTrycf57BRb0ZCMGwpsKWsuea1MC1zIrm44IQZUC4YSUStmlVW8plwJupJs2SylYYozS4zl_Kh6t_fdjssBOgs-R9PrbXSDiTsdjNN_K95t9DpcaVlTwmhTDF7dGMRwOULKenDJQt8bD2FMmrZMyLbmYkJf_oNehDGWhSdKFJBxJQtF95SNIaUIq7thKNFTHvQ-D7p8s57yoEmpeXF_i7uK2wAUgO2BVCS_hniv9X9dfwNvJMHG</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1941922385</pqid></control><display><type>article</type><title>Equipping the 8th Edition American Joint Committee on Cancer Staging for Gastric Cancer with the 15-Node Minimum: a Population-Based Study Using Recursive Partitioning Analysis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Yuan, Shu-Qiang ; Chen, Yu-Tong ; Huang, Ze-Ping</creator><creatorcontrib>Yuan, Shu-Qiang ; Chen, Yu-Tong ; Huang, Ze-Ping</creatorcontrib><description><![CDATA[Bakcground
The recently proposed 8th American Joint Committee on Cancer (AJCC) staging for gastric cancer (GC) did not include the evaluated lymph node (ELN) count as a prognostic indicator. In this study, we performed recursive partitioning analysis (RPA) to objectively combine the 15-ELN threshold and 8th AJCC stage to refine the staging for GC.
Methods
We analyzed 19,018 patients with non-metastatic GC from the Surveillance, Epidemiology, and End Results database. The dataset was randomly divided into training and validation sets.
Results
For each 8th AJCC stage, survival was significantly better for patients with ≥15 ELNs versus those with <15 ELNs (
P
< 0.001 for all). RPA divided non-metastatic GC into seven stages: RPA-IA (8th AJCC IA with ≥15 ELNs), RPA-IB (IA with <15 ELNs and IB/IIA with ≥15 ELNs), RPA-IIA (IB with <15 ELNs and IIB with ≥15 ELNs), RPA-IIB (IIA with <15 ELNs and IIIA with ≥15 ELNs), RPA-IIIA (IIB with <15 ELNs), RPA-IIIB (IIIA with <15 ELNs and IIIB ≥15 ELNs), and RPA-IIIC (IIIB with <15 ELNs and IIIC). The corresponding 5-year survival rates were 84.1, 70.3, 52.8, 41.4, 32.9, 21.7, and 10.2%, respectively (
P
< 0.001 for all pairwise comparisons). The RPA staging outperformed the 8th AJCC staging in terms of discrimination and homogeneity among the SEER training and validation sets, as well as an independent Chinese cohort.
Conclusion
By equipping the 8th AJCC stage with the 15-ELN threshold, the proposed RPA staging is superior to the 8th AJCC staging without overcomplicating.]]></description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-017-3504-0</identifier><identifier>PMID: 28752402</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Aged, 80 and over ; China - epidemiology ; Cohort Studies ; Female ; Fish ; Gastric cancer ; Gastroenterology ; Gastrointestinal surgery ; Humans ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Male ; Medicine ; Medicine & Public Health ; Metastasis ; Middle Aged ; Neoplasm Staging - methods ; Original ; Original Article ; Population-based studies ; Prognosis ; SEER Program ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Surgery ; Survival Rate ; United States - epidemiology</subject><ispartof>Journal of gastrointestinal surgery, 2017-10, Vol.21 (10), p.1591-1598</ispartof><rights>The Author(s) 2017</rights><rights>Journal of Gastrointestinal Surgery is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-71e2b5635368a9e345d67300ae89ea104682c8c83613841f52b7b5a2832c0ac33</citedby><cites>FETCH-LOGICAL-c470t-71e2b5635368a9e345d67300ae89ea104682c8c83613841f52b7b5a2832c0ac33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-017-3504-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-017-3504-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28752402$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yuan, Shu-Qiang</creatorcontrib><creatorcontrib>Chen, Yu-Tong</creatorcontrib><creatorcontrib>Huang, Ze-Ping</creatorcontrib><title>Equipping the 8th Edition American Joint Committee on Cancer Staging for Gastric Cancer with the 15-Node Minimum: a Population-Based Study Using Recursive Partitioning Analysis</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description><![CDATA[Bakcground
The recently proposed 8th American Joint Committee on Cancer (AJCC) staging for gastric cancer (GC) did not include the evaluated lymph node (ELN) count as a prognostic indicator. In this study, we performed recursive partitioning analysis (RPA) to objectively combine the 15-ELN threshold and 8th AJCC stage to refine the staging for GC.
Methods
We analyzed 19,018 patients with non-metastatic GC from the Surveillance, Epidemiology, and End Results database. The dataset was randomly divided into training and validation sets.
Results
For each 8th AJCC stage, survival was significantly better for patients with ≥15 ELNs versus those with <15 ELNs (
P
< 0.001 for all). RPA divided non-metastatic GC into seven stages: RPA-IA (8th AJCC IA with ≥15 ELNs), RPA-IB (IA with <15 ELNs and IB/IIA with ≥15 ELNs), RPA-IIA (IB with <15 ELNs and IIB with ≥15 ELNs), RPA-IIB (IIA with <15 ELNs and IIIA with ≥15 ELNs), RPA-IIIA (IIB with <15 ELNs), RPA-IIIB (IIIA with <15 ELNs and IIIB ≥15 ELNs), and RPA-IIIC (IIIB with <15 ELNs and IIIC). The corresponding 5-year survival rates were 84.1, 70.3, 52.8, 41.4, 32.9, 21.7, and 10.2%, respectively (
P
< 0.001 for all pairwise comparisons). The RPA staging outperformed the 8th AJCC staging in terms of discrimination and homogeneity among the SEER training and validation sets, as well as an independent Chinese cohort.
Conclusion
By equipping the 8th AJCC stage with the 15-ELN threshold, the proposed RPA staging is superior to the 8th AJCC staging without overcomplicating.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>China - epidemiology</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Fish</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Staging - methods</subject><subject>Original</subject><subject>Original Article</subject><subject>Population-based studies</subject><subject>Prognosis</subject><subject>SEER Program</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>United States - epidemiology</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1ks1uEzEUhUcIREvhAdggS2zYGPw742GBFKK0gApUQCV2luO5SVzN2KntKcpb9RHxkLYqSKxs-Xz33HvlU1XPKXlNCWneJEprIjGhDeaSCEweVIdUNRyLmtUPy520FDMpfx5UT1K6IAUkVD2uDphqJBOEHVbXi8vRbbfOr1HeAFJ5gxadyy54NBsgOms8-hScz2gehsHlDICKNjfeQkTfs1lPpasQ0YlJufC30i9XrCZLKvGX0AH67LwbxuEtMugsbMfeTE3we5OgKz5jt0PnafL6BnaMyV0BOjMx_xllep550--SS0-rRyvTJ3h2cx5V58eLH_MP-PTrycf57BRb0ZCMGwpsKWsuea1MC1zIrm44IQZUC4YSUStmlVW8plwJupJs2SylYYozS4zl_Kh6t_fdjssBOgs-R9PrbXSDiTsdjNN_K95t9DpcaVlTwmhTDF7dGMRwOULKenDJQt8bD2FMmrZMyLbmYkJf_oNehDGWhSdKFJBxJQtF95SNIaUIq7thKNFTHvQ-D7p8s57yoEmpeXF_i7uK2wAUgO2BVCS_hniv9X9dfwNvJMHG</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Yuan, Shu-Qiang</creator><creator>Chen, Yu-Tong</creator><creator>Huang, Ze-Ping</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20171001</creationdate><title>Equipping the 8th Edition American Joint Committee on Cancer Staging for Gastric Cancer with the 15-Node Minimum: a Population-Based Study Using Recursive Partitioning Analysis</title><author>Yuan, Shu-Qiang ; Chen, Yu-Tong ; Huang, Ze-Ping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-71e2b5635368a9e345d67300ae89ea104682c8c83613841f52b7b5a2832c0ac33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>China - epidemiology</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Fish</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Staging - methods</topic><topic>Original</topic><topic>Original Article</topic><topic>Population-based studies</topic><topic>Prognosis</topic><topic>SEER Program</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yuan, Shu-Qiang</creatorcontrib><creatorcontrib>Chen, Yu-Tong</creatorcontrib><creatorcontrib>Huang, Ze-Ping</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yuan, Shu-Qiang</au><au>Chen, Yu-Tong</au><au>Huang, Ze-Ping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Equipping the 8th Edition American Joint Committee on Cancer Staging for Gastric Cancer with the 15-Node Minimum: a Population-Based Study Using Recursive Partitioning Analysis</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>21</volume><issue>10</issue><spage>1591</spage><epage>1598</epage><pages>1591-1598</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract><![CDATA[Bakcground
The recently proposed 8th American Joint Committee on Cancer (AJCC) staging for gastric cancer (GC) did not include the evaluated lymph node (ELN) count as a prognostic indicator. In this study, we performed recursive partitioning analysis (RPA) to objectively combine the 15-ELN threshold and 8th AJCC stage to refine the staging for GC.
Methods
We analyzed 19,018 patients with non-metastatic GC from the Surveillance, Epidemiology, and End Results database. The dataset was randomly divided into training and validation sets.
Results
For each 8th AJCC stage, survival was significantly better for patients with ≥15 ELNs versus those with <15 ELNs (
P
< 0.001 for all). RPA divided non-metastatic GC into seven stages: RPA-IA (8th AJCC IA with ≥15 ELNs), RPA-IB (IA with <15 ELNs and IB/IIA with ≥15 ELNs), RPA-IIA (IB with <15 ELNs and IIB with ≥15 ELNs), RPA-IIB (IIA with <15 ELNs and IIIA with ≥15 ELNs), RPA-IIIA (IIB with <15 ELNs), RPA-IIIB (IIIA with <15 ELNs and IIIB ≥15 ELNs), and RPA-IIIC (IIIB with <15 ELNs and IIIC). The corresponding 5-year survival rates were 84.1, 70.3, 52.8, 41.4, 32.9, 21.7, and 10.2%, respectively (
P
< 0.001 for all pairwise comparisons). The RPA staging outperformed the 8th AJCC staging in terms of discrimination and homogeneity among the SEER training and validation sets, as well as an independent Chinese cohort.
Conclusion
By equipping the 8th AJCC stage with the 15-ELN threshold, the proposed RPA staging is superior to the 8th AJCC staging without overcomplicating.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>28752402</pmid><doi>10.1007/s11605-017-3504-0</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1091-255X |
| ispartof | Journal of gastrointestinal surgery, 2017-10, Vol.21 (10), p.1591-1598 |
| issn | 1091-255X 1873-4626 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Aged, 80 and over China - epidemiology Cohort Studies Female Fish Gastric cancer Gastroenterology Gastrointestinal surgery Humans Lymph Nodes - pathology Lymph Nodes - surgery Male Medicine Medicine & Public Health Metastasis Middle Aged Neoplasm Staging - methods Original Original Article Population-based studies Prognosis SEER Program Stomach Neoplasms - mortality Stomach Neoplasms - pathology Surgery Survival Rate United States - epidemiology |
| title | Equipping the 8th Edition American Joint Committee on Cancer Staging for Gastric Cancer with the 15-Node Minimum: a Population-Based Study Using Recursive Partitioning Analysis |
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