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A prediction model for lymph node metastasis in early‐stage gastric cancer: Toward tailored lymphadenectomy
Author(s) -
Kim Su Mi,
Lee Hyuk,
Min ByungHoon,
Kim Jae J.,
An Ji Yeong,
Choi MinGew,
Bae Jae Moon,
Kim Sung,
Sohn Tae Sung,
Lee Jun Ho
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25628
Subject(s) - medicine , lymphadenectomy , stage (stratigraphy) , cancer , lymphatic system , gastrectomy , logistic regression , lymph node , metastasis , incidence (geometry) , lymphovascular invasion , oncology , lymph node metastasis , radiology , pathology , paleontology , physics , optics , biology
Background: The aim of this study was to develop a prediction model for the presence and location of lymph node metastasis (LNM) in early gastric cancer. Method: We reviewed medical records of 4 929 patients who underwent radical gastrectomy for early gastric cancer. Variables of age, sex, lymphatic invasion, depth of invasion, location, gross type, differentiation, and tumor size were analyzed. Logistic regression analysis was used to determine independent predictors of LNM at each LN station. Result: Overall incidence of LNM was 9.1% (448/4 929 patients). For the presence of LNM, risk factors of age, sex, lymphatic invasion, depth of invasion, anatomical part, gross ulceration, size, and tumor differentiation were significantly associated with LNM. The area under the curve (AUC) for predicting LNM after validation was 0.834 for the test set. For the location of LNM, age, sex, lymphatic invasion, depth of invasion, anatomical part, circumferential portion, gross type, differentiation, and tumor size were significantly associated with LNM. The AUC of each LN station was favorable with the test set. Conclusion: Predicting the location of metastatic LNs appeared to be possible in patients with early gastric cancer.