A new predictive model combined of tumor size, lymph nodes count and lymphovascular invasion for survival prognosis in patients with lymph node-negative gastric cancer.
BACKGROUND
Various factors may affect the clinical prognosis of lymph node-negative gastric cancer (GC) patients. This study aimed to provide evaluable prognostic information of combination of tumor size (Ts), lymph nodes count (LNs) and lymphovascular invasion (LVI) in lymph node-negative GC patients.


METHODS
A total of 1,019 node-negative GC patients were enrolled in this retrospective study from 2000 to 2010. The cutoff points of Ts and LNs were determined using X-tile and patients were randomly categorized into training and validation sets by the sample size ratio 1:1. The clinicopathologic characteristics were analyzed and survival prognostic factors were identified, whereas the survival prediction accuracy was also compared by C-index during the different independent prognostic factors.


RESULTS
The cutoff points for Ts were 3cm and 5cm, while 14 was the cutoff point for LNs. Age, T stage, Ts, LNs and LVI were identified as independent prognostic factors in node-negative GC patients, and a new prognostic predictive model, TsNL staging system which was composed of Ts, LNs and LVI, was proposed in this study. Compared with T staging system, significant improvement of predictive accuracy for TsNL system was found. Furthermore, nomogram based on TsNL was more accurate in prognostic prediction than that based on Ts, LNs and LVI, separately.


CONCLUSIONS
Age, T stage, Ts, LNs and LVI were independent prognostic factors in lymph node-negative GC patients. The TsNL staging system, composed of Ts, LNs and LVI, which was closely associated with clinicopathologic features, may improve the prognostic prediction accuracy in node-negative GC patients.
['Zhao|Lin-Yong|LY|', 'Chen|Xiao-Long|XL|', 'Wang|Yi-Gao|YG|', 'Xin|Yue|Y|', 'Zhang|Wei-Han|WH|', 'Wang|Yin-Su|YS|', 'Chen|Xin-Zu|XZ|', 'Yang|Kun|K|', 'Liu|Kai|K|', 'Xue|Lian|L|', 'Zhang|Bo|B|', 'Chen|Zhi-Xin|ZX|', 'Chen|Jia-Ping|JP|', 'Zhou|Zong-Guang|ZG|', 'Hu|Jian-Kun|JK|']
D000328:Adult D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008198:Lymph Nodes D008207:Lymphatic Metastasis D008297:Male D008875:Middle Aged D008954:Models, Biological D009361:Neoplasm Invasiveness D009367:Neoplasm Staging D011379:Prognosis D012189:Retrospective Studies D012307:Risk Factors D013274:Stomach Neoplasms D047368:Tumor Burden
predictive model tumor size lymph nodes count lymphovascular invasion gastric cancer