Evaluation of three lymph node staging systems for prognostic prediction in gastric cancer:A systematic review and meta-analysis

作     者：Ming Cheng Yang Yu Takehiro Watanabe Yutaro Yoshimoto Sanae Kaji Yukinori Yube Munehisa Kaneda Hajime Orita Shinji Mine You-Yong Wu Tetsu Fukunaga 

作者机构：Department of Upper Gastroenterological SurgeryJuntendo University School of MedicineTokyo 113-8431Japan Department of Gastrointestinal SurgeryThe Second Affiliated Hospital of Soochow UniversitySuzhou 215004Jiangsu ProvinceChina Department of Gastrointestinal SurgeryPeking University Cancer HospitalBeijing 100142China 

出 版 物：《World Journal of Gastrointestinal Oncology》 (世界胃肠肿瘤学杂志(英文))

年 卷 期：2025年第17卷第3期

页      面：334-348页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：the Clinical Medical Team Introduction Program of Suzhou No.SZYJTD201804 

主　　题：Gastric cancer Prognostic predictor Overall survival Meta-analysis Pathological lymph nodes Positive lymph node ratio Log odds of positive lymph nodes 

摘      要：BACKGROUND Lymph node status is a critical prognostic factor in gastric cancer(GC),but stage migration may occur in pathological lymph nodes(pN)*** address this,alternative staging systems such as the positive lymph node ratio(LNR)and log odds of positive lymph nodes(LODDS)were *** To assess the prognostic accuracy and stratification efficacy of three nodal staging systems in *** A systematic review identified 12 studies,from which hazard ratios(HRs)for overall survival(OS)were *** analyses,subgroup analyses,publication bias assessments,and quality evaluations were *** enhance comparability,data from studies with identical cutoff values for pN,LNR,and LODDS were *** stratification was then applied to generate Kaplan-Meier(KM)survival curves,assessing the stratification efficacy of three staging *** The HRs and 95%confidence intervals for pN,LNR,and LODDS were 2.16(1.72-2.73),2.05(1.65-2.55),and 3.15(2.15-4.37),respectively,confirming all three as independent prognostic risk factors for *** analysis of HRs demonstrated that LODDS had superior prognostic predictive power over LNR and *** curves for pN(N0,N1,N2,N3a,N3b),LNR(0.1/0.2/0.5),and LODDS(-1.5/-1.0/-0.5/0)revealed significant differences(P0.001)among all prognostic *** differences and standard deviations in 60-month relative survival were 27.93%±0.29%,41.70%±0.30%,and 26.60%±0.28%for pN,LNR,and LODDS,*** All three staging systems are independent prognostic factors for *** demonstrated the highest specificity,making it especially useful for predicting outcomes,while pN was the most effective in homogeneous stratification,offering better patient *** findings highlight the complementary roles of LODDS and pN in enhancing prognostic accuracy and stratification.