Introduction
Methods
Data sources
Inclusion and exclusion criteria
Study selection
Data extraction
Outcomes and quality assessment
Data analysis and statistical methods
Results
Study characteristics
Reference | Year | Single-center/multicenter | Clinical study design | Country | Patient year | Patient | Tumor stage | Age(years) | Population | Neoadjuvant therapy | |
---|---|---|---|---|---|---|---|---|---|---|---|
Number | Male/female | ||||||||||
Gu P [11] | 2021 | Multicenter | retrospective | China | 2001–2011 | 7620 | 5378/2242 | I-III | Median (range): 58.3 (15–89) | undergone curative gastric cancer resection with lymphadenectomy (R0 resection) | No |
Pan S [23] | 2019 | single-center | retrospective | China | 1987–2012 | 1730 | 1250/480 | I-III | Median (IQR): 58 (50–66) | underwent radical gastrectomy | Yes |
Cao H [24] | 2019 | single-center | retrospective | China | 2010–2012 | 877 | 605/272 | I-III | - | gastric adenocarcinoma R0 resection with D2 LN dissection | No |
Toth D [25] | 2017 | Multicenter | retrospective | Hungary | 2005–2010 | 164 | 99/65 | I-IV | Median (range): 66 (35–90) | gastric adenocarcinoma R0 resection | No |
Lee JW [34] | 2016 | single-center | retrospective | Korean | 1990–2012 | 3929 | 2623/1306 | NC | Median (range): 59 (18–91) | underwent curative (R0) resection and extended lymphadenectomy | UKN |
Jian-Hui C [35] | 2016 | single-center | retrospective | China | 1994–2008 | 935 | 636/299 | NC | mean (range): 57.5 (24–87) | gastric adenocarcinoma R0 resection with D2 LN dissection | No |
Spolverato G [15] | 2015 | Multicenter | retrospective | America | 2000–2012 | 804 | 468/336 | NC | Median (IQR): 66.1 (56.7–74.3) | underwent surgical resection of gastric adenocarcinoma | Yes |
Aurello P [36] | 2014 | single-center | retrospective | Italy | 1997–2012 | 177 | 107/70 | NC | mean (range): 65.9 (32–88) | gastric adenocarcinoma who underwent curative gastrectomy (R0) | No |
Xu J [12] | 2013 | single-center | retrospective | China | 2005–2008 | 427 | 281/146 | NC | - | underwent standard D2 radical gastrectomy | UKN |
Liu H [37] | 2013 | single-center | retrospective | China | 2001–2006 | 372 | 240/132 | NC | mean (range): 58.9 (20 − 79) | gastric adenocarcinoma R0 resection with D2 LN dissection and number of lymph nodes retrieved were no less than 15 | Yes |
Qiu MZ [38] | 2012 | single-center | retrospective | China | 1996–2006 | 730 | 522/208 | I-III | mean (range): 60 (24 − 83) | receiving D2 resection carried out by experienced surgeons in our hospital following the Japanese Gastric Cancer Association (JGCA) guidelines | UKN |
Sun Z [14] | 2010 | single-center | prospectively | China | 1980–2008 | 2547 | - | - | - | underwent D2 or D3 lymphadenectomy and achieved radical (R0) resection for histologically proven gastric carcinoma | UKN |
Reference | Year | The number of harvested LNs | The number of metastatic LNs | UICC/AJCC TNM | Follow − up(mouth) | Follow-up | Cutoff | Groups in the study | NOS score | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
LODDS0 | LODDS1 | LODDS2 | LODDS3 | LODDS4 | |||||||||
Gu P [11] | 2021 | Median (range): 58.3 (15–89) | Median (range): 2.0 (0–84) | the 8th edition | Median (range): 87 (2 − 186) | 5-year OS | LODDS 0 (LODDS ≤ -1.5) LODDS 1 (-1.5 < LODDS ≤ -1.0) LODDS 2 (-1.0 < LODDS ≤ -0.5) LODDS 3 (-0.5 < LODDS ≤ 0) LODDS 4 (LODDS > 0) | 1992 | 1567 | 1474 | 1409 | 1178 | 8 |
Pan S [23] | 2019 | Median (IQR): 21 (13–32) | Median (IQR): 1 (0–4) | the 8th edition | Median (IQR): 36.0 (1 − 426) | 5-year OS | LODDS 0 (LODDS ≤ -1.5) LODDS 1 (-1.5 < LODDS ≤ -1.0) LODDS 2 (-1.0 < LODDS ≤ -0.5) LODDS 3 (-0.5 < LODDS ≤ 0) LODDS 4 (LODDS > 0) | 506 | 443 | 324 | 303 | 154 | 8 |
Cao H [24] | 2019 | - | - | the 8th edition | - | 5-year OS | LODDS 0 (LODDS ≤ -0.5) LODDS 1 (-0.5 < LODDS ≤ 0) LODDS 2 (0 < LODDS ≤ 0.5) LODDS 3 (LODDS > 0.5) | 261 | - | 160 | 312 | 144 | 7 |
Toth D [25] | 2017 | mean (range): 10.48 (1–38) | mean (range): 3.22 (0–23) | the 6th, the 7th, and the 8th edition | Median (range): 23.0 (3–136) | 5-year OS | LODDS 0 (LODDS < –1.125) LODDS 1 (–1.125 ≤ LODDS < –0.25) LODDS 2 (–0.25 ≤ LODDS < 0.75) LODDS 3 (LODDS ≥ 0.75) | 29 | - | 75 | 43 | 17 | 8 |
Lee JW [34] | 2016 | mean ± SD: 41.2 ± 16.5 | mean ± SD: 3.22 ± 6.8 | the 7th edition | Median: 69.7 | 5-year OS | LODDS 0 (LODDS ≤ -4) LODDS 1 (-4 < LODDS ≤ -2.5) LODDS 2 (-2.5 < LODDS ≤ -2) LODDS 3 (-2.5 < LODDS ≤ -2) LODDS 4 (LODDS > -0.5) | 1850 | 996 | 226 | 609 | 248 | 8 |
Jian-Hui C [35] | 2016 | mean (range): 24.9 (0–140) | mean (range): 4.61 (0 − 124) | the 7th edition | Median (range): 53.3 (1.3–148.4) | 5-year OS | LODDS 0 (LODDS ≤ -1.5) LODDS 1 (-1.5 < LODDS ≤ -1.0) LODDS 2 (-1.0 < LODDS ≤ -0) LODDS 3 (LODDS > 0) | 277 | 170 | 385 | 103 | 6 | |
Spolverato G [15] | 2015 | Median (IQR): 17 (11–25) | - | the 7th edition | Median: 21 | 5-year OS | LODDS 0 (LODDS ≤ -1.5) LODDS 1 (-1.5 < LODDS ≤ -1.0) LODDS 2 (-1.0 < LODDS ≤ -0.5) LODDS 3 (-0.5 < LODDS ≤ 0) LODDS 4 (LODDS > 0) | 459 | 61 | 63 | 87 | 132 | 8 |
Aurello P [36] | 2014 | mean (range): 26.4 (3 − 73) | mean (range): 6.9 (0–59) | the 7th edition | Median: 77 | 5-year OS | LODDS 0 (LODDS < -1.0) LODDS 1 (-1.0 ≤ LODDS < -0.5) LODDS 2 (-0.5 ≤ LODDS < 0) LODDS 3 (0 ≤ LODDS < 0.5) LODDS 4 (LODDS ≥ 0.5) | 88 | 27 | 31 | 19 | 12 | 8 |
Xu J [12] | 2013 | - | - | the 7th edition | Median (range): 55 (39–81) | 5-year OS | LODDS 0 (LODDS < -1.0) LODDS 1 (-1.0 ≤ LODDS < -0.5) LODDS 2 (-0.5 ≤ LODDS < 0) LODDS 3 (0 ≤ LODDS < 0.5) LODDS 4 (LODDS ≥ 0.5) | 129 | 87 | 85 | 76 | 50 | 8 |
Liu H [37] | 2013 | Median (range): 21 (15 − 66) | Median (range): 3 (0–21) | the 7th edition | Median (range): 52 (3–89) | 5-year OS | LODDS 0 (LODDS < -1.5) LODDS 1 (-1.5 ≤ LODDS < -1.0) LODDS 2 (-1.0 ≤ LODDS < -0.5) LODDS 3 (LODDS ≥ -0.5) | 100 | 64 | 71 | 137 | 8 | |
Qiu MZ [38] | 2012 | Median (range): 16 (0 − 72) | Median (range): 4 (0–70) | the 7th edition | Median (range): 48 (3 − 175) | 5-year OS | LODDS 0 (LODDS < -0.5) LODDS 1 (-0.5 ≤ LODDS < 0) LODDS 2 (0 ≤ LODDS < 0.5) LODDS 3 (LODDS ≥ 0.5) | 305 | 174 | 142 | 109 | 8 | |
Sun Z [14] | 2010 | - | - | the 6th edition | Median (range): 41 (3 − 332) | 5-year OS | LODDS 0 (LODDS ≤ -1.5) LODDS 1 (-1.5 < LODDS ≤ -1.0) LODDS 2 (-1.0 < LODDS ≤ -0.5) LODDS 3 (-0.5 < LODDS ≤ 0) LODDS 4 (LODDS > 0) | 544 | 594 | 533 | 528 | 348 | 8 |
Study analysis
LODDS and OS in GC
Comparisons (vs LODDS0) | OS | ||||
---|---|---|---|---|---|
No. of studies | HR (95% CI) | Heterogeneity | Egger’s Test p Value | ||
I2 (%) | P | ||||
TOTAL studies | |||||
LODDS1 | 10 | 1.62 (1.42, 1.85) | 63.5% | 0.003 | 0.608 |
LODDS2 | 11 | 2.47 (2.02, 3.03) | 86.2% | < 0.001 | 0.799 |
LODDS3 | 11 | 3.15 (2.50, 3.97) | 92.1% | < 0.001 | 0.943 |
LODDS4 | 11 | 4.55 (3.29, 6.29) | 96.6% | < 0.001 | 0.216 |
Yearc | |||||
≥ Median | |||||
LODDS1 | 5 | 1.50 (1.23, 1.82) | 79.4% | 0.001 | |
LODDS2 | 6 | 2.41 (1.88, 3.09) | 83.3% | < 0.001 | |
LODDS3 | 6 | 2.95 (2.04, 4.27) | 95.7% | < 0.001 | |
LODDS4 | 6 | 5.82 (4.30, 7.87) | 90.8% | < 0.001 | |
< Median | |||||
LODDS1 | 5 | 1.78 (1.56, 2.04) | 0.0% | 0.714 | |
LODDS2 | 5 | 2.58 (1.76, 3.80) | 89.3% | < 0.001 | |
LODDS3 | 5 | 3.38 (2.80, 4.09) | 53.9% | 0.07 | |
LODDS4 | 5 | 3.32 (2.11, 5.23) | 95.9% | < 0.001 | |
Country | |||||
East Asia | |||||
LODDS1 | 8 | 1.65 (1.49, 1.84) | 39.9% | 0.113 | |
LODDS2 | 8 | 2.56 (2.15, 3.05) | 77.5% | < 0.001 | |
LODDS3 | 8 | 3.33 (2.86, 3.87) | 77.8% | < 0.001 | |
LODDS4 | 8 | 4.89 (3.90, 6.14) | 90.6% | < 0.001 | |
non-East Asia | |||||
LODDS1 | 2 | 1.57 (0.69, 3.57) | 86.7% | 0.006 | |
LODDS2 | 3 | 2.21 (1.04, 4.71) | 88.7% | < 0.001 | |
LODDS3 | 3 | 2.79 (1.21, 6.44) | 90.2% | < 0.001 | |
LODDS4 | 3 | 3.60 (1.55, 8.32) | 90.1% | < 0.001 | |
Patient no.d | |||||
≥ Median | |||||
LODDS1 | 5 | 1.60 (1.42, 1.81) | 56.0% | 0.059 | |
LODDS2 | 6 | 2.47 (2.01, 3.04) | 83.2% | < 0.001 | |
LODDS3 | 6 | 3.23 (2.71, 3.85) | 83.7% | < 0.001 | |
LODDS4 | 6 | 4.05 (2.63, 6.24) | 98.0% | < 0.001 | |
< Median | |||||
LODDS1 | 5 | 1.76 (1.24, 2.49) | 73.7% | 0.004 | |
LODDS2 | 5 | 2.50 (1.55, 4.03) | 87.0% | < 0.001 | |
LODDS3 | 5 | 3.17 (1.77, 5.68) | 92.0% | < 0.001 | |
LODDS4 | 5 | 5.43 (3.04, 9.69) | 91.0% | < 0.001 | |
Neoadjuvant therapy | |||||
No | |||||
LODDS1 | 3 | 1.85 (1.64, 2.07) | 0.0% | 0.381 | |
LODDS2 | 5 | 3.04 (2.58, 3.58) | 29.2% | 0.227 | |
LODDS3 | 4 | 4.03 (3.66, 4.43) | 0.0% | 0.975 | |
LODDS4 | 5 | 6.36 (4.50, 8.99) | 81.3% | < 0.001 | |
All | |||||
LODDS1 | 3 | 1.38 (1.05, 1.82) | 67.1% | 0.048 | |
LODDS2 | 3 | 2.00 (1.39, 2.88) | 87.5% | < 0.001 | |
LODDS3 | 3 | 2.47 (1.42, 4.30) | 95.6% | < 0.001 | |
LODDS4 | 2 | 2.41 (1.34, 4.36) | 97.5% | < 0.001 | |
UKN | |||||
LODDS1 | 4 | 1.59 (1.35, 1.89) | 49.0% | 0.118 | |
LODDS2 | 3 | 2.26 (1.54, 3.31) | 83.0% | 0.003 | |
LODDS3 | 4 | 3.07 (2.53, 3.71) | 66.2% | < 0.001 | |
LODDS4 | 4 | 4.29 (3.17, 5.82) | 86.4% | < 0.001 |
Subgroup analysis
Publication bias
Comparison of the homogeneity of prognostic assessments
LODDS0 | LODDS1 | LODDS2 | LODDS3 | LODDS4 | χ2 | pa | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
No | 5-YSR | No | 5-YSR | No | 5-YSR | No | 5-YSR | No | 5-YSR | |||
pN stage | ||||||||||||
N0 | 2524 | 83.1% | 1331 | 71.3% | 216 | 61.8% | 27 | 38.9% | 131.606 | < 0.001 | ||
N1 | 42 | 70.8% | 981 | 68.2% | 956 | 49.7% | 429 | 31.5% | 87 | 18.9% | 179.709 | < 0.001 |
N2 | 143 | 68.2% | 835 | 52.2% | 772 | 33.3% | 326 | 18.6% | 171.909 | < 0.001 | ||
N3 | 8 | 75.0% | 204 | 47.3% | 871 | 29.8% | 1232 | 14.6% | 152.506 | < 0.001 | ||
χ2 | 3.416 | 2.981 | 11.473 | 2.625 | 3.991 | |||||||
pb | 0.065 | 0.395 | 0.009 | 0.453 | 0.136 | |||||||
rN stage | ||||||||||||
rN0 | 2497 | 82.9% | 1328 | 71.2% | 214 | 61.4% | 25 | 38.4% | 125.64 | < 0.001 | ||
rN1 | 39 | 74.7% | 907 | 68.7% | 496 | 49.1% | 18 | 33.0% | 60.39 | < 0.001 | ||
rN2 | 231 | 67.0% | 1471 | 51.1% | 966 | 32.5% | 30 | 15.4% | 138.074 | < 0.001 | ||
rN3 | 1070 | 30.6% | 993 | 17.3% | 50.051 | < 0.001 | ||||||
rN4 | 612 | 12.8% | - | - | ||||||||
χ2 | 1.411 | 2.493 | 9.203 | 1.742 | 5.81 | |||||||
pc | 0.235 | 0.287 | 0.01 | 0.628 | 0.055 |