To compare the prognostic value of AJCC-N, LNR, and LODDs in gastric adenocarcinoma, emphasizing the need for external validation.
Key Findings:
AJCC-N, LNR, and LODDs were strongly correlated across datasets (P < 0.001), indicating their relevance in clinical settings.
LODDs showed slightly larger AUCs than LNR and AJCC-N for predicting 1-, 3-, and 5-year survival, suggesting its superior predictive capability.
Multivariable Cox regression identified LODDs, sex, age, race, T stage, and tumor size as independent risk factors for overall survival, highlighting the importance of these factors.
Interpretation:
LODDs reflects metastatic tumor burden and demonstrates favorable prognostic performance compared to AJCC-N and LNR, potentially guiding treatment decisions.
Limitations:
Further validation in well-defined lymphadenectomy cohorts is warranted, and potential biases or confounding factors should be considered.
Conclusion:
The LODDs-based nomogram may serve as a useful tool for individualized prognostic assessment.
