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A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated–Type Intramucosal Gastric Cancer

Author

Listed:
  • Jeung Hui Pyo
  • Hyuk Lee
  • Byung-Hoon Min
  • Jun Haeng Lee
  • Min Gew Choi
  • Jun Ho Lee
  • Tae Sung Sohn
  • Jae Moon Bae
  • Kyoung-Mee Kim
  • Hyeon Seon Ahn
  • Sin-Ho Jung
  • Sung Kim
  • Jae J Kim

Abstract

Background and Aim: Endoscopic submucosal dissection (ESD) for undifferentiated type early gastric cancer is regarded as an investigational treatment. Few studies have tried to identify the risk factors that predict lymph-node metastasis (LNM) in intramucosal poorly differentiated adenocarcinomas (PDC). This study was designed to develop a risk scoring system (RSS) for predicting LNM in intramucosal PDC. Methods: From January 2002 to July 2015, patients diagnosed with mucosa-confined PDC, among those who underwent curative gastrectomy with lymph node dissection were reviewed. A risk model based on independent predicting factors of LNM was developed, and its performance was internally validated using a split sample approach. Results: Overall, LNM was observed in 5.2% (61) of 1169 patients. Four risk factors [Female sex, tumor size ≥ 3.2 cm, muscularis mucosa (M3) invasion, and lymphatic-vascular involvement] were significantly associated with LNM, which were incorporated into the RSS. The area under the receiver operating characteristic curve for predicting LNM after internal validation was 0.69 [95% confidence interval (CI), 0.59–0.79]. A total score of 2 points corresponded to the optimal RSS threshold with a discrimination of 0.75 (95% CI 0.69–0.81). The LNM rates were 1.6% for low risk (

Suggested Citation

  • Jeung Hui Pyo & Hyuk Lee & Byung-Hoon Min & Jun Haeng Lee & Min Gew Choi & Jun Ho Lee & Tae Sung Sohn & Jae Moon Bae & Kyoung-Mee Kim & Hyeon Seon Ahn & Sin-Ho Jung & Sung Kim & Jae J Kim, 2016. "A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated–Type Intramucosal Gastric Cancer," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-11, May.
    • Handle: RePEc:plo:pone00:0156207
    DOI: 10.1371/journal.pone.0156207
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