{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:17Z","timestamp":1787016977076,"version":"build-2736575974"},"reference-count":34,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Domestic Visiting Study Project for Outstanding Young Talents in Colleges and Universities in Anhui Province","award":["gxgnfx2021183"],"award-info":[{"award-number":["gxgnfx2021183"]}]},{"name":"Major Project of Natural Science of Anhui Provincial Department of Education","award":["KJ2019ZD73"],"award-info":[{"award-number":["KJ2019ZD73"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,8,10]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the prognostic efficacy of lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) in node-positive cardia gastric adenocarcinoma (CGA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A registry-based retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Patients diagnosed with node-positive CGA in the Surveillance, Epidemiology, and End Results database from 2010 to 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 1038 patients were enrolled and randomly assigned (7:3) to the training set (n=723) or validating set (n=315).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Cancer-specific survival (CSS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The baseline characteristics of the training and validation sets were similar. Based on the optimal cut-off values, LNR was classified into low (&lt;0.09), medium (0.09~0.33) and high (&gt;0.33) groups; LODDS was also classified into low (&lt;\u22122.09), medium (\u22122.09~\u22120.65) and high (&gt;\u22120.65) groups. CSS was significantly different across LNR and LODDS subgroups. The Harrell concordance index of the N stage was lower than that of the LNR or LODDS. The Akaike information criterion of the N stage was higher than that of the LNR or LODDS. Independent predictors included race, T stage, M stage and LNR (or LODDS), and they were incorporated into nomograms for 1-year, 2-year and 5-year CSS prediction. Calibration plots showed satisfactory results for internal and external validity of the nomogram.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LNR and LODDS staging methods have better prognostic efficacy than the traditional N staging method in CGA with node metastasis. Moreover, the two values are promising substitutes for N staging in nomogram development when other independent prognostic factors are incorporated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-050378","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T13:36:32Z","timestamp":1629725792000},"page":"e050378","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Prognostic value of different lymph node staging methods for node-positive cardia gastric cancer: a register-based retrospective cohort study"],"prefix":"10.1136","volume":"11","author":[{"given":"Xiao-Qing","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Basic Medicine, Anhui Medical College, Hefei, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Basic Medicine, Anhui Medical College, Hefei, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7665-8675","authenticated-orcid":false,"given":"Cheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Anhui Province Cancer Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,23]]},"reference":[{"key":"2025120601012097000_11.8.e050378.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"2025120601012097000_11.8.e050378.2","doi-asserted-by":"crossref","first-page":"6114","DOI":"10.1002\/cam4.2497","article-title":"Risk factors predisposing to cardia gastric adenocarcinoma: insights and new perspectives","volume":"8","author":"Abdi","year":"2019","journal-title":"Cancer Med"},{"key":"2025120601012097000_11.8.e050378.3","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/jso.23799","article-title":"Clinicopathological features and prognosis of gastric cardia adenocarcinoma: a multi-institutional US study","volume":"111","author":"Amini","year":"2015","journal-title":"J Surg Oncol"},{"key":"2025120601012097000_11.8.e050378.4","doi-asserted-by":"crossref","unstructured":"Sobin L , Gospodarowicz M , Wittekind C . 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