Evaluating log odds of positive lymph nodes as a prognostic tool in differentiated gastric cancer: A retrospective study

doi:10.3748/wjg.v31.i21.107029

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Jun 7, 2025 (publication date) through Jun 6, 2025

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Jun 7, 2025; 31(21): 107029
Published online Jun 7, 2025. doi: 10.3748/wjg.v31.i21.107029

Table 1 Univariate and multivariate Cox regression analyses of overall survival prognostic factors in 2103 gastric cancer patients

Patient characteristics		Univariate analysis		Multivariate analysis
Patient characteristics		HR (95%CI)	P value	HR (95%CI)	P value
Sex	Female	Reference	-	-	-
Sex	Male	1.200 (0.998-1.444)	0.052	-	-
Age	< 60	Reference	-	Reference	-
Age	≥ 60	1.390 (1.214-1.591)	< 0.001	1.409 (1.198-1.657)	< 0.001
BMI	Normal	Reference	-	Reference	-
	Low	1.406 (1.118-1.768)	0.004	1.018 (0.705-1.470)	0.927
	High	0.810 (0.677-0.971)	0.022	0.843 (0.556-1.279)	0.422
Family history	No	Reference	-	-	-
Family history	Yes	1.034 (0.957-1.118)	0.398	-	-
Smoking history	No	Reference	-	-	-
Smoking history	Yes	1.104 (0.952-1.279)	0.191	-	-
Drinking history	No	Reference	-	Reference	-
Drinking history	Yes	1.220 (1.044-1.425)	0.012	1.144 (0.970-1.350)	0.110
Surgery methods	Open	Reference	-	Reference	-
Surgery methods	Laparoscopy	0.531 (0.384-0.739)	< 0.001	0.655 (0.473-0.907)	0.011
Pathological type	NMGC	Reference	-	-	-
Pathological type	MGC	1.163 (0.857-1.578)	0.322	-	-
Vascular tumor thrombus	No	Reference	-	Reference	-
Vascular tumor thrombus	Yes	1.435 (1.222-1.684)	< 0.001	1.031 (0.871-1.221)	0.722
Nerve invasion	No	Reference	-	Reference	-
Nerve invasion	Yes	1.540 (1.312-1.808)	< 0.001	1.079 (0.912-1.277)	0.374
Differentiation	Moderate	Reference	-	Reference	-
Differentiation	Poor	1.344 (1.158-1.599)	< 0.001	1.268 (1.086-1.479)	0.003
NPLN	NPLN1	Reference	-	Reference	-
NPLN	NPLN2	2.472 (2.122-2.879)	< 0.001	1.466 (1.161-1.851)	0.001
NTLN	NTLN1	Reference	-	Reference	-
NTLN	NTLN2	1.200 (1.026-1.404)	0.024	1.073 (0.909-1.267)	0.404
LNR	LNR1	Reference	-	Reference	-
LNR	LNR2	2.573 (2.184-3.032)	< 0.001	1.485 (1.157-1.906)	0.002
LODDS	LODDS1	Reference	-	Reference	-
LODDS	LODDS2	2.569 (2.174-3.036)	< 0.001	1.515 (1.185-1.938)	< 0.001
pN	N1 + N2	Reference	-	Reference	-
pN	N3a + N3b	2.364 (2.0382.742)	< 0.001	1.431 (1.163-1.760)	< 0.001
pTNM	I	Reference	-	Reference	-
	II	2.747 (0.984-7.669)	0.054	2.159 (0.770-6.053)	0.143
	III	8.922 (3.339-23.842)	< 0.001	4.238 (1.558-11.527)	0.005
Recurrence or metastasis	No	Reference	-	Reference	-
Recurrence or metastasis	Yes	2.202 (1.800-2.694)	< 0.001	1.792 (1.458-2.201)	< 0.001
CA19-9	Low	Reference	-	Reference	-
CA19-9	High	1.819 (1.558-2.123)	< 0.001	1.480 (1.213-1.804)	< 0.001
CA125	Low	Reference	-	Reference	-
CA125	High	1.607 (1.239-2.084)	< 0.001	1.718 (1.399-2.109)	< 0.001
AFP	Low	Reference	-	Reference	-
AFP	High	1.536 (1.177-2.004)	0.002	1.289 (1.015-1.638)	0.038
CA242	Low	Reference	-	Reference	-
CA242	High	1.788 (1.515-2.110)	< 0.001	1.123 (0.908-1.390)	< 0.284
CA72-4	Low	Reference	-	Reference	-
CA72-4	High	1.415 (1.195-1.674)	< 0.001	1.400 (1.209-1.622)	< 0.001
CEA	Low	Reference	-	Reference	-
CEA	High	1.327 (1.179-1.482)	< 0.001	1.430 (1.238-1.653)	< 0.001

CI: Confidence interval; HR: Hazard ratio; BMI: Body mass index; MGC: Mucinous gastric adenocarcinoma; NMGC: Non-mucinous gastric adenocarcinoma; pTNM: Pathological tumor-node-metastasis; NPLN: Number of positive lymph nodes; NTLN: Number of total lymph nodes; LNR: Lymph node ratio; LODDS: Log odds of positive lymph nodes; pN: American Joint Committee on Cancer pathologic N stage; CA: Carbohydrate antigen; AFP: Alpha-fetoprotein; CEA: Carcinoembryonic antigen.

Table 2 Baseline characteristics of patients according to the log odds of positive lymph nodes score before and after propensity score matching, n (%)

Patient characteristics	Raw cohort			PSM cohort
Patient characteristics	LODDS1 (n = 928)	LODDS2 (n = 1175)	P value	LODDS1 (n = 736)	LODDS2 (n = 736)	P value
Sex	-	-	0.196	-	-	0.050
Male	732 (78.9)	899 (76.5)	-	580 (78.8)	564 (76.6)	-
Female	196 (21.1)	276 (23.5)	-	156 (21.2)	172 (23.4)	-
Age	-	-	0.041	-	-	0.764
< 60	320 (34.5)	456 (38.8)	-	263 (35.7)	284 (38.6)	-
≥ 60	608 (65.5)	719 (61.2)	-	473 (64.3)	452 (61.4)	-
BMI	-	-	0.072	-	-	0.934
Low	81 (8.7)	115 (9.8)	-	67 (9.1)	72 (9.7)	-
Normal	623 (67.1)	737 (62.7)	-	489 (66.4)	486 (66.0)	-
High	224 (24.2)	323 (27.5)	-	180 (24.5)	17824.3)	-
Family history	-	-	0.428	-	-	0.183
No	607 (65.5)	749 (63.7)	-	479 (65.1)	464 (63.0)	-
Yes	321 (34.5)	426 (36.3)	-	257 (34.9)	272 (37.0)	-
Smoking history	-	-	0.157	-	-	0.780
No	483 (52.0)	648 (55.1)	-	391 (53.1)	395 (53.7)	-
Yes	445 (48.0)	527 (44.9)	-	345 (46.9)	341 (46.3)	-
Drinking history	-	-	0.259	-	-	0.619
No	650 (70.0)	796 (67.7)	-	514 (69.8)	521 (70.8)	-
Yes	278 (30.0)	379 (32.3)	-	222 (30.2)	215 (29.2)	-
Surgery method	-	-	< 0.001	-	-	0.090
Open	786 (84.7)	1080 (91.9)	-	662 (89.9)	646 (87.8)	-
Laparoscopy	142 (15.3)	95 (8.1)	-	74 (10.1)	90 (12.2)	-
Pathological type	-	-	0.042	-	-	0.721
MGC	49 (5.3)	88 (7.5)	-	47 (6.4)	50 (6.8)	-
NMGC	879 (94.7)	1087 (92.5)	-	669 (93.6)	686 (93.2)	-
Nerve invasion	-	-	< 0.001	-	-	0.164
No	469 (50.5)	357 (30.4)		326 (44.3)	311 (42.3)	-
Yes	459 (49.5)	818 (69.6)		410 (55.7)	425 (57.7)	-
Vascular tumor thrombus	-	-	< 0.001	-	-	0.177
No	478 (51.5)	308 (26.2)	-	316 (42.9)	283 (38.5)	-
Yes	450 (48.5)	867 (73.8)	-	420 (57.1)	453 (61.5)	-
pTNM	-	-	< 0.001	-	-	0.086
I	72 (7.8)	6 (0.5)	-	25 (3.4)	6 (0.8)	-
II	241 (26.0)	72 (6.1)	-	173 (23.5)	63 (8.6)	-
III	615 (66.3)	1097 (93.4)	-	538 (73.1)	667 (90.6)	-
CEA	-	-	< 0.001	-	-	0.176
Low	731 (79.1)	840 (71,5)	-	575 (78.1)	508 (69.0)	-
High	194 (20.9)	335 (28.5)	-	161 (21.9)	228 (31.0)	-
AFP	-	-	0.296	-	-	0.110
Low	873 (94.1)	1092 (92.9)		694 (94.3)	685 (93.1)	-
High	55 (5.9)	83 (7.1)		42 (5.7)	51 (6.9)	-
CA19-9	-	-	< 0.001	-	-	0.051
Low	732 (78.9)	793 (67.5)	-	563 (76.5)	504 (68.5)	-
High	196 (21.1)	382 (32.5)	-	173 (23.5)	232 (31.5)	-
CA72-4	-	-	< 0.001	-	-	0.408
Low	760 (81.9)	881 (75.0)	-	594 (80.7)	564 (76.6)	-
High	168 (18.1)	294 (25.0)	-	142 (19.3)	172 (23.4)	-
CA125	-	-	0.053	-	-	0.956
Low	878 (94.6)	1087 (92.5)	-	695 (94.4)	685 (93.1)	-
High	50 (5.4)	88 (7.5)	-	41 (5.6)	51 (6.9)	-
CA242	-	-	< 0.001	-	-	0.120
Low	782 (84.3)	878 (74.7)	-	603 (81.9)	555 (75.4)	-
High	146 (15.7)	297 (25.3)	-	133 (18.1)	181 (24.6)	-
Differentiation	-	-	< 0.001	-	-	-
Well	9 (1.0)	6 (0.6)	-	-	-	-
Moderate	629 (67.7)	655 (55.7)	-	-	-	-
Poor	290 (31.3)	514 (43.7)	-	-	-	-
NPLN	-	-	< 0.001	-	-	-
NPLN1	892 (96.1)	272 (23.1)	< 0.001	-	-	-
NPLN2	36 (3.9)	903 (76.90)	-	-	-	-
NTLN	-	-	0.014	-	-	-
NTLN1	613 (66.1)	835 (71.1)	-	-	-	-
NTLN2	315 (33.9)	340 (28.9)	-	-	-	-
LNR
LNR1	928 (100)	0	< 0.001	-	-	-
LNR2	0	1175 (100)	-	-	-	-
pN	-	-	< 0.001	-	-	-
N1+N2	603 (65.0)	22 (1.9)	-	-	-	-
N3a+N3b	325 (35.0)	1153 (98.1)	-	-	-	-

PSM: Propensity score matching; BMI: Body mass index; MGC: Mucinous gastric adenocarcinoma; NMGC: Non-mucinous gastric adenocarcinoma; pTNM: Pathological tumor-node-metastasis; NPLN: Number of positive lymph nodes; NTLN: Number of total lymph nodes; LNR: Lymph node ratio; LODDS: Log odds of positive lymph nodes; pN: American Joint Committee on Cancer pathologic N stage; CA: Carbohydrate antigen; AFP: Alpha-fetoprotein; CEA: Carcinoembryonic antigen.

Table 3 Comparison of the prediction performance of different staging systems

	AIC	BIC	C-index	Linear trend χ² score
Poor
LODDS	16.512	25.891	0.607	45.074
pN	16.706	26.086	0.604	41.386
LNR	16.548	25.927	0.605	37.060
NPLN	16.661	26.040	0.606	38.398
Moderate
LODDS	17.308	27.622	0.651	107.014
pN	17.350	27.664	0.623	97.529
LNR	17.317	27.631	0.646	121.010
NPLN	17.367	27.681	0.640	117.545

AIC: Akaike information criterion; BIC: Bayesian information criterion; C-index: Concordance index; LODDS: Log odds of positive lymph nodes; pN: American Joint Committee on Cancer pathologic N stage; LNR: Lymph node ratio; NPLN: Number of positive lymph nodes.

Citation: Deng MC, Chen K, Bao QM, Huang YX, Zhang CK, Zhong YK, He HY, Zu D, Liang C, Liu HD, Hu YC, Liu GX, He YH, Wu WX, Zhou JN, Teng YS, Jing J, Shi Y, Chung CYS, Yu CH, Du YA, Ye Z, Cheng XD. Evaluating log odds of positive lymph nodes as a prognostic tool in differentiated gastric cancer: A retrospective study. World J Gastroenterol 2025; 31(21): 107029
URL: https://www.wjgnet.com/1007-9327/full/v31/i21/107029.htm
DOI: https://dx.doi.org/10.3748/wjg.v31.i21.107029