Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2024; 16(5): 1745-1755
Published online May 15, 2024. doi: 10.4251/wjgo.v16.i5.1745
Different lymph node staging systems for predicting the prognosis of colorectal neuroendocrine neoplasms
Yuan-Yi Zhang, Yue-Wei Cai, Xia Zhang
Yuan-Yi Zhang, Department of Pathology, Zhaoqing Medical College, Zhaoqing 526020, Guangdong Province, China
Yue-Wei Cai, Department of Emergency, Zhaoqing Second People’s Hospital, Zhaoqing 526020, Guangdong Province, China
Xia Zhang, Department of Pathology and Physiology, Zhaoqing Medical College, Zhaoqing 526020, Guangdong Province, China
Author contributions: Zhang YY conceived and designed the study; Zhang YY, Cai YW, and Zhang X collected the data, analyzed, and interpreted the data; Zhang YY wrote the manuscript, and provided critical revisions that are important for the intellectual content; and all authors approved the final version of the manuscript.
Supported by the Zhaoqing Science and Technology Innovation Guidance Project, No. 2022040314032.
Institutional review board statement: SEER database belongs to public databases, the patients involved in the database have obtained ethical approval, users can download relevant data for free for research and publish relevant articles, and our study is based on open-source data, and the Zhaoqing Medical College do not require research using publicly available data to be submitted for review to their ethics committee, so there are no ethical issues and other conflicts of interest.
Informed consent statement: The informed consent was waived from the patients since the SEER database belongs to public databases.
Conflict-of-interest statement: There are no conflicts of interest.
Data sharing statement: The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Yi Zhang, MM, Department of Pathology, Zhaoqing Medical College, No. 12 Fengle Road, Zhaoqing New District, Zhaoqing 526020, Guangdong Province, China. yyzhang_zqmedco@163.com
Received: November 15, 2023
Peer-review started: November 15, 2023
First decision: January 30, 2024
Revised: February 20, 2024
Accepted: March 18, 2024
Article in press: March 18, 2024
Published online: May 15, 2024
Processing time: 176 Days and 11.3 Hours
ARTICLE HIGHLIGHTS
Research background

Colorectal neuroendocrine neoplasms (NENs) are a rare malignancy that exhibit a poor prognosis when lymph node metastasis occurs, which greatly reduces the survival rates of patients. Few studies have investigated the predictive significance of lymph node ratio (LNR), positive lymph node (PLN), and log odds of PLNs (LODDS) staging systems for colorectal NENs.

Research motivation

In this study, we investigated the predictive values of various lymph node staging systems on the prognosis of colorectal NENs treated surgically, and compare their predictive values, providing a reference for the improvement of lymph node staging of colorectal NENs.

Research objectives

To investigate the predictive values of LNR, PLN, and LODDS staging systems on the prognosis of colorectal NENs treated surgically, and compare their predictive values.

Research methods

The present study utilized data extracted from a publicly available Surveillance, Epidemiology, and End Results database. X-tile software was utilized to identify most suitable thresholds for categorizing the LNR, PLN, and LODDS. We employed multivariate cox analysis to assess the associations of LNR, PLN, and LODDS with the prognosis of colorectal NENs. C-index was used for assessing the predictive effectiveness.

Research results

A total of 895 patients with colorectal NENs treated surgically were selected for this study. The training set comprised 627 patients, while the testing set consisted of 268 patients. After adjusting all confounding factors, PLN, LNR, and LODDS staging systems were linked with mortality in patients with colorectal NENs treated surgically. We found that LODDS staging had a higher prognostic value for patients with colorectal NENs treated surgically than PLN and LNR staging systems.

Research conclusions

LNR, PLN, and LODDS were found to significantly predict the prognosis of patients with colorectal NENs treated surgically. LODDS staging system might be potential to serve as a more effective prognostic indicator for colorectal NENs patients undergoing surgical treatment compared to PLN and LNR staging systems.

Research perspectives

We analyzed the predictive values of various lymph node staging systems on the prognosis of colorectal NENs treated surgically. After performing validation, LODDS staging system might be potential to serve as a more effective prognostic indicator for colorectal NENs patients undergoing surgical treatment compared to PLN and LNR staging systems. This could offer valuable insights into the significance of various lymph node staging systems in predicting the prognosis of colorectal NENs patients treated surgically.