title: A novel grade-lymph node ratio model predicts the prognosis of the advanced gastric cancer patients after neoadjuvant radiotherapy.
abstract: Although local advanced gastric cancer (AGC) could benefit from neoadjuvant radiotherapy (NRT), there are few studies evaluating patients' survival after NRT. In current study, we aimed to investigate the value of prognostic factors in AGC patients after NRT and to evaluate whether post-therapy pathological characteristics were predictive factors in these patients. We retrospectively analyzed AGC patients who underwent NRT from Surveillance, Epidemiology, and End Results (SEER) Database. The patients' clinical and post-therapy pathological characteristics were analyzed. The best cutoff points for continuous variables were identified by X-tile. The discrimination of risk factors were compared by receiver operating characteristic (ROC) curve. As a result, 1,429 AGC patients were included into this study. In the multivariate analysis, the lymph nodes status and histology grade were significant risk factors for DSS (disease special survival). Then, we propose a novel Grade-lymph node Ratio (G-R) staging system for the AGC patients' survival prognosis. Clearly, the new G-R staging system has a more-accurate 3-year and 5-year DSS prediction than the AJCC staging system (p = 0.001, 0.007, respectively). In conclusions, the current large, general population-based study demonstrated that the G-R staging system resulting in more-accurate DSS prediction. It could be regarded as a reliable classification for AGC patients after NRT in future.
authors.affiliation: Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Infectious Disease Epidemiology, Lu'an People's Hospital, Lu'an, China.
authors.forename: Mingxue
authors.initials: M
authors.lastname: Su
authors.affiliation: Department of Urologic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Gan
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Anqing
authors.initials: A
authors.lastname: Zhang
authors.affiliation: Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Zixue
authors.initials: Z
authors.lastname: Ren
authors.affiliation: Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Xucai
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Shikai
authors.initials: S
authors.lastname: Hong
authors.affiliation: Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Shengying
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China.
authors.forename: Rongxin
authors.initials: R
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D018714:Radiotherapy, Adjuvant; D018426:SEER Program; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D055815:Young Adult
keywords: SEER; gastric cancer; neoadjuvant radiotherapy; survival analysis