European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
Treating a single tumor deposits as two lymph node metastases can improve the accuracy of gastric cancer prognosis assessment.
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Xu Ran, Li Yang, Zhao Haiyuan, Wang Zhengguang, Zhang Yisheng, Zhao Jun
Аннотация
BACKGROUND: Tumor deposits (TDs) are acknowledged as a prognostic factor for gastric cancer (GC); however, the integration of TDs into the tumor-node-metastasis (TNM) staging remains a subject of ongoing debate.
OBJECTIVE: This study explores the conversion relationship between TDs and metastatic lymph node (MLN), and proposes novel strategies for integrating TDs into the TNM staging framework.
METHODS: A retrospective analysis of 5503 cases of GC treated at Yijishan Hospital, Wannan Medical College, was conducted from January 2012 to November 2024.
RESULTS: A total of 661 patients were diagnosed with TDs, yielding a positive rate of 12.01 % (661/5503). Among these patients, 638 were successfully matched with 638 TDs-negative patients in a 1:1 ratio. The number of TDs was associated with a poorer prognosis before and after propensity score matching (PSM). The modified TNM staging system, which assigns a single TD to two lymph node metastases, demonstrated superior prognostic predictive performance compared to the 8th edition American Joint Committee on Cancer (AJCC) TNM staging system and other modified staging systems (c-index: 0.641, χ2: 239.435, AIC: 11049.208). After counting each TD as two MLNs in the TDs-positive group and subsequent re-staging via the TNM system, no statistically significant differences in prognosis were found between the mTDs (+) subgroups and their corresponding TDs (-) subgroups (P > 0.05).
CONCLUSION: The number of TDs is associated with a poor prognosis in patients with GC. Considering a single TD as equivalent to two MLNs can improve the accuracy of prognostic assessments in GC.
OBJECTIVE: This study explores the conversion relationship between TDs and metastatic lymph node (MLN), and proposes novel strategies for integrating TDs into the TNM staging framework.
METHODS: A retrospective analysis of 5503 cases of GC treated at Yijishan Hospital, Wannan Medical College, was conducted from January 2012 to November 2024.
RESULTS: A total of 661 patients were diagnosed with TDs, yielding a positive rate of 12.01 % (661/5503). Among these patients, 638 were successfully matched with 638 TDs-negative patients in a 1:1 ratio. The number of TDs was associated with a poorer prognosis before and after propensity score matching (PSM). The modified TNM staging system, which assigns a single TD to two lymph node metastases, demonstrated superior prognostic predictive performance compared to the 8th edition American Joint Committee on Cancer (AJCC) TNM staging system and other modified staging systems (c-index: 0.641, χ2: 239.435, AIC: 11049.208). After counting each TD as two MLNs in the TDs-positive group and subsequent re-staging via the TNM system, no statistically significant differences in prognosis were found between the mTDs (+) subgroups and their corresponding TDs (-) subgroups (P > 0.05).
CONCLUSION: The number of TDs is associated with a poor prognosis in patients with GC. Considering a single TD as equivalent to two MLNs can improve the accuracy of prognostic assessments in GC.