br Conc http www glpbio com simage GC
This study developed an accurate LNR-based prognostic model for predicting the survival outcome after D2 surgery in gastric cancer patients with metastasis to more than 15 regional MPP+ Iodide nodes. This model might assist clinicians in the prognostic stratification of such patients and convince eligible patients to receive adjuvant chemotherapy.
Conflict of interest
The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
This research did not receive any specific grant from funding agencies in the public, commercial, or nonprofit sectors.
The authors thank all the members of the Cancer Center of Chang Gung Memorial Hospital for assisting with data collection. They would also like to extend their gratitude to Ms. Shu-Fang Huang and Ms. Vengi Ho from the Center for Clinical Research in Chang Gung Memorial Hospital for their invaluable contribution in biostatistics analysis.
Appendix A. Supplementary data
2. Kamangar F, Dores GM, Anderson WF. Patterns of cancer inci-dence, mortality, and prevalence across five continents:
defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24(14): 2137e2150.
3. D’Angelica M, Gonen M, Brennan MF, Turnbull AD, Bains M, Karpeh MS. Patterns of initial recurrence in completely resected gastric adenocarcinoma. Ann Surg. 2004;240(5):808e816.
6. Yeh CN, Wang SY, Hsu JT, et al. N3 subclassification incorpo-rated into the final pathologic staging of gastric cancer: a modified system based on current AJCC staging. Medicine (Baltimore). 2015;94(8):e575.
7. Greene FL, Page DL, Fleming ID, et al. American Joint Com-mittee on Cancer (AJCC) Cancer Staging Manual. 6th ed. New York, NY: Springer; 2002.
8. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. American Joint Committee on Cancer (AJCC) Cancer Staging Manual. 7th ed. Chicago: Springer; 2010.
9. Amin MB. American Joint Committee on Cancer (AJCC) Cancer Staging Manual. 8th ed. Chicago: Springer; 2016.
11. Liu YY, Fang WL, Wang F, et al. Does a higher cutoff value of lymph node retrieval substantially improve survival in patients with advanced gastric cancer? e time to embrace a new digit. Oncologist. 2017;22(1):97e106.
12. Marchet A, Mocellin S, Ambrosi A, et al. The ratio between metastatic and examined lymph nodes (N ratio) is an inde-pendent prognostic factor in gastric cancer regardless of the type of lymphadenectomy: results from an Italian multicentric study in 1853 patients. Ann Surg. 2007;245(4):543e552.
15. Xu DZ, Geng QR, Long ZJ, et al. Positive lymph node ratio is an independent prognostic factor in gastric cancer after d2 resection regardless of the examined number of lymph nodes. Ann Surg Oncol. 2009;16(2):319e326.
16. Sun Z, Zhu GL, Lu C, et al. The impact of N-ratio in minimizing stage migration phenomenon in gastric cancer patients with insufficient number or level of lymph node retrieved: results from a Chinese mono-institutional study in 2159 patients. Ann Oncol. 2009;20(5):897e905.
17. Wolmark N, Rockette H, Fisher B, et al. The benefit of leucovorin-modulated fluorouracil as postoperative adjuvant therapy for primary colon cancer: results from national surgi-cal adjuvant breast and bowel project protocol C-03. J Clin Oncol. 1993;11(10):1879e1887.
18. Nakajima T, Kinoshita T, Nashimoto A, et al. Randomized controlled trial of adjuvant uraciletegafur versus surgery alone for serosa-negative, locally advanced gastric cancer. Br J Surg. 2007;94(12):1468e1476.