接受新辅助放化疗后，可切除胃食管癌（GEC）检查的淋巴结数量会减少，这可能无法准确判断N分期。因此，我们的研究评估了一种基于GEC患者接受新辅助放化疗后淋巴结阳性对数比值（LODDS）的新分期模型的临床意义。 共有1 130例病理诊断为GEC的患者从2004年至2017年接受了新辅助放化疗。选择2019年纳入国家癌症研究所监测、流行病学和结果（SEER）数据库的数据进行分析。根据 AJCC TNM 分期系统（第八版）和 LODDS 对淋巴结进行分期。通过Kaplan-Meier方法评估两个系统的患者预后，通过Akaike信息标准和贝叶斯信息标准评估淋巴结分期的差异。另外，我中心914例患者进行了外部验证。与传统的TNM分期系统相比，新的TLODDSM分期系统由I期、II期、IIIA期、IIIB期和IVA期组成，决策曲线分析显示：新的分期系统对于不同的决策阈值比旧的分期系统具有更高的好处。新分期系统的Akaike信息准则和贝叶斯信息准则均低于旧分期系统，表明TLODDSM分期系统预测患者预后的敏感性更高。此外，新分期系统中的IIIB或-IVA期患者受益于辅助化疗。我中心的外部验证数据支持了这一结论。相比TNM分期系统，TLODDSM分期系统在预测完成新辅助放化疗的GEC患者预后、指导患者辅助化疗方面具有显着优势。©2024。作者（s）。

After receiving neoadjuvant chemoradiation, the number of examined lymph nodes in resectable gastroesophageal cancer (GEC) will decrease, this may not accurately determine the N staging. So our study evaluates the clinical significance of a new staging model based on the logarithmic odds of positive lymph nodes (LODDS) in patients with GEC after receiving neoadjuvant chemoradiation.A total of 1 130 patients with pathologically diagnosed GEC who received neoadjuvant chemoradiation from 2004 to 2019 included in the National Cancer Institute Surveillance, Epidemiology, and Results (SEER) database were selected for analysis. Lymph nodes were staged according to the AJCC TNM staging system (eighth edition) and LODDS. Patient prognosis across the two systems were evaluated by the Kaplan-Meier method, differences in node staging were evaluated by the Akaike information criterion and Bayesian information criterion. In addition, 914 patients from our center were externally validated.Compared to the traditional TNM staging system, the new TLODDSM staging system was comprised of stage I, stage II, stage IIIA, stage IIIB, and stage IVA, and decision curve analysis showed that the new staging system had higher benefits for different decision thresholds than the old staging system. The Akaike information criterion and Bayesian information criterion of the new staging system was lower than those of the old staging system, indicating the sensitivity of the TLODDSM staging system for predicting the prognosis of patients was higher. In addition, stage-IIIB or -IVA patients in the new staging system benefited from adjuvant chemotherapy. The externally validated data from our center supported this conclusion.Compared to the TNM staging system, the TLODDSM staging system has significant advantages in predicting prognosis of patients with GEC who have completed neoadjuvant chemoradiation, guiding the adjuvant chemotherapy for patients.© 2024. The Author(s).