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01 Dec 2020
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Which lymph node staging system best predicts prognosis in gastric carcinoma?

11 Jan 2021

The three lymph node (LN) staging systems assessed in a recent study—the eighth TNM staging system, lymph node ratio (LNR, ratio between positive and total LN), and a new anatomic-based classification (Choi classification)—show comparable prognostic performance, but LNR-based classification better stratifies patients with resected gastric carcinoma (GC).

LN staging of GC remains controversial. To address this, the researchers conducted this retrospective study of 377 GC patients in a tertiary hospital in Spain. They collected clinical data, reviewed histologic slides, and performed univariate and multivariate analyses of disease-free survival (DFS) and overall survival (OS).

Of the patients identified, 315 met the eligibility criteria. On univariate analysis, all LN classifications significantly correlated with tumour death and progression (p<0.001).

The three staging systems were independent prognostic factors for DFS, with area under the curve ratios of 0.738 for Choi, 0.730 for N stage, and 0.735 for LNR classification.

Additionally, TNM and LNR classifications were independent prognostic factors for OS, while Choi classification was an independent factor only in patients with ≥16 LN resected. Area under the curve ratios were 0.707, 0.728, and 0.732 for Choi, N stage, and LNR classifications, respectively.

Of note, Kaplan-Meier curves depending on LNR classification demonstrated the best stratification of patients for both OS and DFS.

“GC is an aggressive disease with high mortality rates,” the researchers said.

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
2 days ago
Among patients with moderate-to-severe psoriasis, the use of biologics appears to lower the risk of being hospitalized for the novel coronavirus disease (COVID-19), a new study has found.