J Gastric Cancer.
2023 Apr;23(2):355-364. 10.5230/jgc.2023.23.e18.
A Nomogram for Predicting Extraperigastric Lymph Node Metastasis in Patients With Early Gastric Cancer
- Affiliations
-
- 1Division of Gastrointestinal Surgery, Department of Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
- 2Department of Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
- 3Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 4Department of Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
- 5Department of Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
- 6Division of Gastrointestinal Surgery, Department of Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- KMID: 2547750
- DOI: http://doi.org/10.5230/jgc.2023.23.e18
Abstract
- Background
There are no clear guidelines to determine whether to perform D1 or D1+ lymph node dissection in early gastric cancer (EGC). This study aimed to develop a nomogram for estimating the risk of extraperigastric lymph node metastasis (LNM).
Materials and Methods
Between 2009 and 2019, a total of 4,482 patients with pathologically confirmed T1 disease at 6 affiliated hospitals were included in this study. The basic clinicopathological characteristics of the positive and negative extraperigastric LNM groups were compared. The possible risk factors were evaluated using univariate and multivariate analyses. Based on these results, a risk prediction model was developed. A nomogram predicting extraperigastric LNM was used for internal validation.
Results
Multivariate analyses showed that tumor size (cut-off value 3.0 cm, odds ratio [OR]=1.886, P=0.030), tumor depth (OR=1.853 for tumors with sm2 and sm3 invasion, P=0.010), cross-sectional location (OR=0.490 for tumors located on the greater curvature, P=0.0303), differentiation (OR=0.584 for differentiated tumors, P=0.0070), and lymphovascular invasion (OR=11.125, P<0.001) are possible risk factors for extraperigastric LNM. An equation for estimating the risk of extraperigastric LNM was derived from these risk factors. The equation was internally validated by comparing the actual metastatic rate with the predicted rate, which showed good agreement.
Conclusions
A nomogram for estimating the risk of extraperigastric LNM in EGC was successfully developed. Although there are some limitations to applying this model because it was developed based on pathological data, it can be optimally adapted for patients who require curative gastrectomy after endoscopic submucosal dissection.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Significance of Lymph Node Metastasis in Early Gastric Cancer
- Risk Factors Affecting Lymph Node Metastasis and Recurrence in Early Gastric Cancer
- Comparison of Laparoscopy-Assisted by Conventional Open Distal Gastrectomy and Extraperigastric Lymph Node Dissection in Early Gastric Cancer
- Predictive value of chest computed tomography for axillary lymph node metastasis in patients with breast cancer A retrospective cohort study
- Comparison of Laparoscopy-assisted Distal Gastrectomy with Open Distal Gastrectomy for Early Gastric Cancer
