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Journal of Gastroenterology

, Volume 51, Issue 10, pp 961–970 | Cite as

Risk stratification and predictive risk-scoring model for lymph node metastasis in early gastric cancer

  • Masau Sekiguchi
  • Ichiro Oda
  • Hirokazu Taniguchi
  • Haruhisa Suzuki
  • Shinji Morita
  • Takeo Fukagawa
  • Shigeki Sekine
  • Ryoji Kushima
  • Hitoshi Katai
Original Article—Alimentary Tract

Abstract

Background

We are increasingly experiencing difficulty in deciding whether to perform gastrectomy after noncurative endoscopic resection of early gastric cancer (EGC) for patients at high risk for surgery. If the differences in risk for lymph node metastasis (LNM) on the basis of noncurative status are understood, the decision becomes easier. The present study aimed to stratify the LNM risk and develop and validate a risk-scoring model for predicting LNM.

Methods

By retrospectively reviewing 3131 patients with solitary EGC who underwent gastrectomy with lymphadenectomy at our institution between July 1997 and May 2013, LNM risk was stratified and a risk-scoring model was developed on the basis of the identified independent risk factors for LNM. The scoring was validated using 352 other surgically resected EGC cases. The discriminatory accuracy of the scoring was measured by area under receiver operating characteristic curve (AUROC).

Results

LNM was detected in 386 of 3131 cases. LNM risk in each subgroup, stratified by the identified independent risk factors, such as tumor size, depth, histological type, ulcerative findings, and lymphovascular involvement, considerably varied from 0 % to >50 % even among the current guidelines’ noncurative subgroups. An 11-point scoring model was built, and AUROCs were 0.84 (95 % confidence interval, 0.82–0.86) and 0.82 (0.75–0.88) in the development and validation sets, respectively.

Conclusions

The present study revealed detailed LNM risk stratification data, and developed and validated an 11-point scoring model.

Keywords

Early gastric cancer Endoscopic resection Lymph node metastasis Mixed-type histology Risk stratification 

Notes

Compliance with ethical standards

Conflict of interest

The author(s) declare that they have no competing interests.

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Copyright information

© Japanese Society of Gastroenterology 2016

Authors and Affiliations

  • Masau Sekiguchi
    • 1
  • Ichiro Oda
    • 1
  • Hirokazu Taniguchi
    • 2
  • Haruhisa Suzuki
    • 1
  • Shinji Morita
    • 3
  • Takeo Fukagawa
    • 3
  • Shigeki Sekine
    • 2
  • Ryoji Kushima
    • 2
    • 4
  • Hitoshi Katai
    • 3
  1. 1.Endoscopy DivisionNational Cancer Center HospitalTokyoJapan
  2. 2.Pathology and Clinical Laboratory DivisionNational Cancer Center HospitalTokyoJapan
  3. 3.Gastric Surgery DivisionNational Cancer Center HospitalTokyoJapan
  4. 4.Department of Clinical Laboratory Medicine and Diagnostic PathologyShiga University of Medical ScienceShigaJapan

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