Archives

  • 2019-07
  • 2019-08
  • 2019-09
  • 2019-10
  • 2019-11
  • 2020-03
  • 2020-07
  • 2020-08
  • br The American Joint Committee on Cancer

    2020-08-18


    The American Joint Committee on Cancer ZVAD FMK (AJCC) TNM staging system has been recognized as the most important prognostic factor and the basis of treatment in GC. However, heterogeneities in the prognosis of individual patients with the same stage still exist.
    Please cite this article as: Lin J-X et al., Association of the age-adjusted Charlson Comorbidity Index and systemic ZVAD FMK with survival in gastric cancer patients after radical gastrectomy, European Journal of Surgical Oncology, https://doi.org/10.1016/j.ejso.2019.07.010
    J.-X. Lin et al. / European Journal of Surgical Oncology xxx (xxxx) xxx 7
    In this study, a new prognostic model was established by combining the new ANLR maker and pTNM staging. Compared with the predictive accuracy of traditional TNM staging, the pre-dictive accuracy of the new model combining the ANLR with pTNM was significantly better, which suggested that the ANLR could improve the accuracy of prognosis assessment of GC. Therefore, in clinical practice, the ANLR can be used as a supplement for TNM staging in preoperative risk stratification to effectively guide the treatment strategy and postoperative follow-up of GC patients.
    This study had some limitations. First, as a retrospective study, it is inevitable that there may be selection bias. Second, some un-avoidable confounding factors may exist in this study, such as ed-ucation level, diet or alcohol intake, which may affect the evaluation of the preoperative NLR and ACCI. Third, the consistency of the condition of the patients before preoperative blood drawing may not be guaranteed. Nevertheless, this study found that the ACCI is significantly related to the preoperative NLR in a large cohort. Based on these findings, we established a novel prognostic model, the ANLR. The ANLR combined with the ACCI and preop-erative NLR can effectively improve the predictive accuracy of the prognosis of patients with GC. In clinical practice, the ANLR could be considered a supplement to the traditional staging system to improve the prognosis evaluation of GC patients and guide indi-vidualized treatment strategies.
    Author contributions
    Lin JX, Huang YQ, Zheng CH, Huang CM and Li P conceived of the study, analyzed the data, and drafted the manuscript; Tu RH, Li P, Xie JW, Wang JB, and Li P helped revise the manuscript critically for important intellectual content; Lu J, Chen QY, Cao LL, and Lin M helped collect data and design the study.
    Acknowledgements
    The authors thank all the medical staff who contributed to the maintenance of the medical record database.
    Appendix A. Supplementary data
    Funding
    This study was supported by the Scientific and technological innovation joint capital projects of Fujian Province, China (No.2016Y9031) and Minimally invasive medical center of Fujian Province (No. [2017]171).
    Conflict of interest
    There are no conflicts of interest or financial ties to disclose from any of author.
    Ethical approval
    All procedures followed were in accordance with the ethical standards of the responsible committee on human experimenta-tion (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or a substitute for it was obtained from all patients for being included in the study.
    References
    [5] Hamilton TD, Mahar AL, Haas B, Beyfuss K, Law CHL, Karanicolas PJ, et al. The impact of advanced age on short-term outcomes following gastric cancer resection: an ACS-NSQIP analysis. Gastric Cancer; 2017 [Epub ahead of print]. [6] Takeshita H, Ichikawa D, Komatsu S, Kubota T, Okamoto K, Shiozaki A, et al. Surgical outcomes of gastrectomy for elderly patients with gastric cancer. World J Surg 2013;37:2891. [7] Huang CM, Tu RH, Lin JX, Zheng CH, Li P, Xie JW, et al. A scoring system to predict the risk of postoperative complications after laparoscopic gastrectomy for gastric cancer based on a large-scale retrospective study. Medicine (Bal-tim) 2015;94:e812.
    [8] Lee KG, Lee HJ, Yang JY, Oh SY, Bard S, Suh YS, et al. Risk factors associated with complication following gastrectomy for gastric cancer: retrospective analysis of prospectively collected data based on the Clavien-Dindo system. J Gastrointest Surg 2014;18(7):1269e77.
    [9] Hsu JT, Liu MS, Wang F, Chang CJ, Hwang TL, Jan YY, et al. Standard radical gastrectomy in octogenarians and nonagenarians with gastric cancer: are short-term surgical results and long-term survival substantial? J Gastrointest Surg 2012;16(4):728e37.
    [15] Choi Y, Kim JW, Nam KH, Han SH, Kim JW, Ahn SH, et al. Systemic inflam-mation is associated with the density of immune cells in the tumor micro-environment of gastric cancer. Gastric Cancer 2017;20(4):602e11.