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BMC Cancer

, 16:92

Surgical oncology, cancer imaging, and interventional therapeutics

Abstract

BackgroundEarly gastric cancer is defined as a lesion confined to the mucosa or submucosa, regardless of the size or lymph node metastasis. Treatment methods include endoscopic mucosal resection or endoscopic submucosal dissection, wedge resection, laparoscopically assisted gastrectomy and open gastrectomy. Lymph node metastasis is strong related with survival and recurrence. Therefore, the likelihood of lymph node metastasis is one of the most important factors when determining the most appropriate treatment.

MethodsWe retrospectively analyzed 597 patients who underwent D2 gastrectomy for early gastric cancer. The relationship between lymph node metastasis and clinicopathological features was analyzed. Using multivariate logistic regression analyses, we created a nomogram to predict the lymph node metastasis probability for early gastric cancer. Receiver operating characteristic analyses was performed to assess the predictive value of the model.

ResultsIn the present study, 58 9.7 % early gastric cancer patients were histologically shown to have lymph node metastasis. The multivariate logistic regression analysis demonstrated that the age at diagnosis, differentiation status, the presence of ulcers, lymphovascular invasion and depth of invasion were independent risk factors for lymph node metastasis in early gastric cancer. Additionally, the tumor macroscopic type, size and histology type significantly correlated with these important independent factors. We constructed a predictive nomogram with these factors for lymph node metastasis in early gastric cancer patients, and the discrimination was good with the AUC of 0.860 95 % CI: 0.809–0.912.

ConclusionsWe developed an effective nomogram to predict the incidence of lymph node metastasis for early gastric cancer patients.

KeywordsEarly gastric cancer Lymph node metastasis Nomogram AbbreviationsEGCearly gastric cancer

EMRendoscopic mucosal resection

ESDendoscopic submucosal dissection

ROCoperating characteristic curve

AUCarea under the curve

CIconfidence intervals

Zhixue Zheng and Yinan Zhang are the first authors.

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Autor: Zhixue Zheng - Yinan Zhang - Lianhai Zhang - Ziyu Li - Xiaojiang Wu - Yiqiang Liu - Zhaode Bu - Jiafu Ji

Fuente: https://link.springer.com/







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