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Negative Lymph Node Count is an Independent Impact Factor for Predicting the Specific Survival of Primary Duodenal Neoplasms under Surgical Procedures by Li Zheng

Background: The work aimed to assess the influence of negative lymph node numbers on specific survival of primary duodenal neoplasms under surgical procedures.
Methods: This study focused on the primary duodenal neoplasm patients that have been registered in the “surveillance, epidemiology, and end results” (SEER). First, the important factors were screened by the Kaplan-Meier (Log-rank) in R and the Cox’s proportional hazards regression model. Subsequently, a nomogram was established based on key proportional hazards including the negative lymph node count. Finally, the analysis of the specific survival by Kaplan-Meier (Log-rank) and X-Tile was performed to identify the cutoff values of negative lymph node numbers.
Results: There were 463 selected patients. Five impact factors were screened including the negative lymph node count (between 10 and 32), age (< 73), differentiation of cancers (well or moderate), primary tumors’ invasion to tissues’ superficial parts, no distant metastasis. The C-index of the nomogram in this paper was 0.74.
Conclusions: The negative lymph node count and the other four factors were used for predicting the specific survival of primary duodenal neoplasms under surgical treatment, and the highest 2-year cancer’s specific survival occurred when the negative lymph node numbers were 10 - 32. Besides, the nomogram in this paper proved to be more useful in predicting the survival effects than the traditional American Joint Committee on Cancer classifica-tion methods.

DOI: 10.7754/Clin.Lab.2019.191131