A Nomogram for Predicting Extraperigastric Lymph Node Metastasis in Patients With Early Gastric Cancer
Hyun Joo Yoo1, Hayemin Lee2, Han Hong Lee3
1Division of Gastrointestinal Surgery, Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
Journal of Gastric Cancer
|May 2, 2023
Summary
This study developed a nomogram to predict extraperigastric lymph node metastasis (LNM) in early gastric cancer (EGC). The tool helps determine lymph node dissection extent for improved patient treatment.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Oncology
Background:
- Guidelines for lymph node dissection in early gastric cancer (EGC) are unclear.
- D1 vs. D1+ dissection decisions lack clear criteria.
- This study addresses the need for risk stratification for extraperigastric lymph node metastasis (LNM).
Purpose of the Study:
- To develop a predictive model (nomogram) for extraperigastric LNM in EGC.
- To aid in surgical decision-making regarding lymph node dissection extent.
- To improve risk assessment for patients with early gastric cancer.
Main Methods:
- Analysis of 4,482 patients with T1 stage EGC from 2009-2019.
- Comparison of clinicopathological characteristics between LNM-positive and LNM-negative groups.
- Univariate and multivariate analyses to identify risk factors for extraperigastric LNM.
Main Results:
- Key risk factors identified: tumor size (>3.0 cm), tumor depth (sm2/sm3 invasion), lymphovascular invasion.
- Protective factors identified: greater curvature location, tumor differentiation.
- A validated nomogram equation was developed to estimate extraperigastric LNM risk.
Conclusions:
- A nomogram for predicting extraperigastric LNM in EGC was successfully developed.
- The model shows good agreement between predicted and actual metastatic rates.
- The nomogram is particularly useful for patients undergoing curative gastrectomy post-endoscopic submucosal dissection.
