Prognostic value of LODDS in late-onset gastric adenocarcinoma: analysis of SEER, TCGA, and external multicenter cohorts

作者：Hengbo Xia, Yong Qian, Qingqing Pang, Aman Xu, Jie Hu · 发表于：Frontiers in Oncology · 年份：2025 · DOI：10.3389/fonc.2025.1619504 · 被引用次数：4 · 研究领域：Gastric Cancer Management and Outcomes、Esophageal Cancer Research and Treatment、Cholangiocarcinoma and Gallbladder Cancer Studies

Introduction: Accurate survival prediction is crucial for optimizing individualized treatment and follow-up in patients with late-onset gastric adenocarcinoma (LOGA). Traditional lymph node staging systems such as N-stage, positive lymph node (PLN), and lymph node ratio (LNR) have limitations in predictive accuracy, especially in cases with inadequate lymph node dissection. The log odds of positive lymph nodes (LODDS), a novel nodal staging metric that incorporates both positive and negative lymph nodes through a log-transformed ratio, has shown potential advantages by providing a more stable and refined assessment of nodal involvement. Materials and methods: This study included 10,361 LOGA patients from the SEER database, 135 from TCGA, and 252 from two medical centers. A novel prognostic model was constructed based on a training cohort from SEER and validated using internal (SEER testing set) and external (TCGA and hospital datasets) cohorts. The model incorporated age, gender, grade, size, chemotherapy, and LODDS. Four staging systems (TNM-stage, PLN-stage, LNR-stage, LODDS-stage) were compared using the Akaike Information Criterion (AIC), Concordance Index (C-index) and time-dependent Area Under the Curve (AUC). LODDS-stage model, the most effective model, was used to build nomograms for overall survival (OS) and cause-specific survival (CSS). Model performance was evaluated using calibration curves, Decision Curve Analysis (DCA), and Kaplan-Meier analysis. Results: Univa...