دورية أكاديمية
EVALUATION OF N-RATIO IN SELECTING PATIENTS FOR ADJUVANT CHEMORADIOTHERAPY AFTER D2-GASTRECTOMY
| العنوان: | EVALUATION OF N-RATIO IN SELECTING PATIENTS FOR ADJUVANT CHEMORADIOTHERAPY AFTER D2-GASTRECTOMY |
|---|---|
| المؤلفون: | COSTA JUNIOR,Wilson Luiz da, COIMBRA,Felipe José Fernández, BATISTA,Thales Paulo, RIBEIRO,Héber Salvador de Castro, DINIZ,Alessandro Landskron |
| المصدر: | Arquivos de Gastroenterologia v.50 n.4 2013 |
| بيانات النشر: | Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBG Sociedade Brasileira de Hepatologia - SBH Sociedade Brasileira de Endoscopia Digestiva - SOBED |
| سنة النشر: | 2013 |
| المجموعة: | SciELO Brazil (Scientific Electronic Library Online) |
| مصطلحات موضوعية: | Stomach Neoplasms, Lymph Node Excision, Adjuvant Chemotherapy, Adjuvant Radiotherapy |
| الوصف: | Context Whether adjuvant chemoradiotherapy may contribute to improve survival outcomes after D2-gastrectomy remains controvertial. Objective To explore the clinical utility of N-Ratio in selecting gastric cancer patients for adjuvant chemoradiotherapy after D2-gastrectomy. Methods A retrospective cohort study was carried out on gastric cancer patients who underwent D2-gastrectomy alone or D2-gastrectomy plus adjuvant chemoradiotherapy (INT-0116 protocol) at the Hospital A. C. Camargo from September 1998 to December 2008. Statistical analysis were performed using multiple conventional methods, such as c-statistic, adjusted Cox's regression and stratified survival analysis. Results Our analysis involved 128 patients. According to c-statistic, the N-Ratio (i.e., as a continuous variable) presented “area under ROC curve” (AUC) of 0.713, while the number of metastatic nodes presented AUC of 0.705. After categorization, the cut-offs provide by Marchet et al. displayed the highest discriminating power – AUC value of 0.702. This N-Ratio categorization was confirmed as an independent predictor of survival using multivariate analyses. There also was a trend of better survival by adding of adjuvant chemoradiotherapy only for patients with milder degrees of lymphatic spread – 5-year survival of 23.1% vs 66.9%, respectively (HR = 0.426, 95% CI 0.150–1.202; P = 0.092). Conclusions This study confirms the N-Ratio as a tool to improve the lymph node metastasis staging in gastric cancer and suggests the cut-offs provided by Marchet et al. as the best way for its categorization after a D2-gastrectomy. In these settings, the N-Ratio appears a useful tool to select patients for adjuvant chemoradiotherapy, and the benefit of adding this type of adjuvancy to D2-gastrectomy is suggested to be limited to patients with milder degrees of lymphatic spread (i.e., NR2, 10%–25%). |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text/html |
| اللغة: | English |
| الإتاحة: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032013000400257Test |
| رقم الانضمام: | edsbas.3DBB1148 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |