Difficulty of predicting the presence of lymph node metastases in patients with clinical early stage gastric cancer: a case control study

BMC Cancer

Research Article

Hyunsoo Chung¹  Hyun Beak Shin²  Hui-Jae Bang²  Woo Jin Hyung²  Yoon Young Choi²  Hyung-Il Kim²  Jae-Ho Cheong²  Sung Hoon Noh³  Masatoshi Nakagawa⁴  Shuangxi Li⁵  Sang Hyuk Seo⁶  Ji Yeong An⁷ 

[1] Department of Internal Medicine, Institute of Gastroenterology, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea;Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, 120-752, Seoul, South Korea;Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, 120-752, Seoul, South Korea;Brain Korea 21 PLUS Project for Medical Science, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea;Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, 120-752, Seoul, South Korea;Department of Gastric Surgery, Tokyo Medical and Dental University, Tokyo, Japan;Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, 120-752, Seoul, South Korea;Department of Gastrointestinal Surgery, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, China;Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, 120-752, Seoul, South Korea;Department of Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea;Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, 120-752, Seoul, South Korea;Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 06351, Seoul, South Korea;

关键词: Early gastric cancer;    Lymph node metastasis;    Preoperative prediction;   

DOI  :  10.1186/s12885-015-1940-3

 received in 2015-09-12, accepted in 2015-11-19,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe relationship between pathological factors and lymph node metastasis of pathological stage early gastric cancer has been extensively investigated. By contrast, the relationship between preoperative factors and lymph node metastasis of clinical stage early gastric cancer has not been investigated. The present study was to investigate discrepancies between preoperative and postoperative values.MethodsFrom January 2011 to December 2013, 1042 patients with clinical stage early gastric cancer who underwent gastrectomy with lymphadenectomy were enrolled. Preoperative and postoperative values were collected for subsequent analysis. Receiver operating characteristics curves were computed using independent predictive factors.ResultsSeveral discrepancies were observed between preoperative and postoperative values, including existence of ulcer, gross type, and histology (all McNemar p-values were <0.001). Multivariate analyses identified the following independent predictive factors for lymph node metastasis: postoperative values including age (p = 0.002), tumor size (p < 0.001), and tumor depth (p < 0.001); preoperative values including age (p = 0.017), existence of ulcer (p = 0.037), tumor size (p = 0.009), and prediction of the presence of lymph node metastasis in computed tomography scans (p = 0.002). These postoperative and preoperative independent predictive factors produced areas under the receiver operating characteristics curves of 0.824 and 0.660, respectively.ConclusionsSurgeons need to be aware of limitations in preoperative predictions of the presence of lymph node metastasis for clinical stage early gastric cancer.

【 授权许可】

CC BY   
© Nakagawa et al. 2015