Difficulty of predicting the presence of lymph node metastases in patients with clinical early stage gastric cancer: a case control study. Issue 1 (December 2015)

• Record Type: Journal Article
• Authors: Nakagawa, Masatoshi; Choi, Yoon; An, Ji; Chung, Hyunsoo; Seo, Sang; Shin, Hyun; Bang, Hui-Jae; Li, Shuangxi; Kim, Hyung-Il; Cheong, Jae-Ho; Hyung, Woo; Noh, Sung
• Is Part Of: BMC cancer. Volume 15:Issue 1(2015)
• Page Start: 1
• Page End: 9
• Publication Date: 2015-12
• Subjects: Early gastric cancer -- Lymph node metastasis -- Preoperative prediction; Cancer -- Periodicals; 616.994005
• DOI: 10.1186/s12885-015-1940-3
• Languages: English
• ISSNs: 1471-2407

Abstract

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 McNemarp -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.