A prediction model for lymph node metastasis in early‐stage gastric cancer: Toward tailored lymphadenectomy

Abstract

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. K E Y W O R D S gastric cancer, lymph node metastasis, prediction SUPPORTING INFORMATION Additional supporting information may be found online in the Supporting Information section. How to cite this article: Kim SM, Lee H, Min B-H, et al. A prediction model for lymph node metastasis in early-stage gastric cancer: Toward tailored lymphadenectomy. J Surg

Nomograms for Predicting the Lymph Node Metastasis in Early Gastric Cancer by Gender: A Retrospective Multicentric Study

“…Previous studies have explored the risk factors for LNM of EGC patients and established corresponding prediction models (8)(9)(10)(11). Previous study reported that the female sex is an independent risk factor for LNM in patients with EGC (12).…”

Oncologic Feasibility of Proximal Gastrectomy in Upper Third Advanced Gastric and Esophagogastric Junctional Cancer

“…The presence of middle third invasion was defined according to the pathology report, when the epicenter of a cancer located in the upper third area involved the middle third area. In previous studies, factors related to LN metastasis in early gastric cancer included tumor size, depth of invasion, histological type, presence or absence of vascular invasion, and lymphatic invasion [ 10 11 12 ]. Tumor location, depth, size, and histological type are also known to affect the incidence and distribution of LN metastasis in advanced gastric cancer [ 13 14 ].…”

Clinicopathological Features and Prognosis of Gastric Cancer in Young Patients

“…However, several recent studies demonstrated the prognosis in young gastric cancer patients was equal to or better than that of the older gastric cancer patients. [1][2][3][4] Authors showed the overall 5-year survival for the older group was significantly lower than that for the younger group. 5 And there was no significant difference in 5-year cancer-specific survival for both groups.…”