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Quantitative Nodal Burden and Mortality Across Solid Cancers. Journal of the National Cancer Institute Nguyen, A. T., Luu, M., Nguyen, V. P., Lu, D. J., Shiao, S. L., Kamrava, M., Atkins, K. M., Mita, A. C., Scher, K. S., Spratt, D. E., Faries, M. B., Daskivich, T. J., Lin, D. C., Chen, M. M., Clair, J. M., Sandler, H. M., Ho, A. S., Zumsteg, Z. S. 2022; 114 (7): 1003-1011

Abstract

Nodal staging systems vary substantially across solid tumors, implying heterogeneity in the behavior of nodal variables in various contexts. We hypothesized, in contradiction to this, that metastatic lymph node (LN) number is a universal and dominant predictor of outcome across solid tumors.We performed a retrospective cohort analysis of 1?304?498 patients in the National Cancer Database undergoing surgery between 2004 and 2015 across 16 solid cancer sites. Multivariable Cox regression analyses were constructed using restricted cubic splines to model the association between nodal number and mortality. Recursive partitioning analysis (RPA) was used to derive nodal classification systems for each solid cancer based on metastatic LN count. The reproducibility of these findings was assessed in 1?969?727 patients from the Surveillance, Epidemiology, and End Results registry. Two-sided tests were used for all statistical analyses.Consistently across disease sites, mortality risk increased continuously with increasing number of metastatic LNs (P?

View details for DOI 10.1093/jnci/djac059

View details for PubMedID 35311991

View details for PubMedCentralID PMC9275768