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

Authors
 Masatoshi Nakagawa  ;  Yoon Young Choi  ;  Ji Yeong An  ;  Hyunsoo Chung  ;  Sang Hyuk Seo  ;  Hyun Beak Shin  ;  Hui-Jae Bang  ;  Shuangxi Li  ;  Hyung-Il Kim  ;  Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Sung Hoon Noh 
Citation
 BMC CANCER, Vol.15 : 943, 2015 
Journal Title
 BMC CANCER 
Issue Date
2015
MeSH
dult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Male ; Middle Aged ; Postoperative Period ; Preoperative Period ; Prognosis ; ROC Curve ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery
Keywords
Early gastric cancer ; Lymph node metastasis ; Preoperative prediction
Abstract
BACKGROUND: The 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. METHODS: From 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. RESULTS: Several 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. CONCLUSIONS: Surgeons need to be aware of limitations in preoperative predictions of the presence of lymph node metastasis for clinical stage early gastric cancer.
Files in This Item:
T201506416.pdf Download
DOI
10.1186/s12885-015-1940-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Chung, Hyun Soo(정현수)
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157340
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