A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated-Type Intramucosal Gastric Cancer.
<h4>Background and aim</h4>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...
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0156207&type=printable |
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| author | 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 |
| author_facet | 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 |
| author_sort | Jeung Hui Pyo |
| collection | DOAJ |
| description | <h4>Background and aim</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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 (<2 points) and 8.9% for high-risk (≥2 points) patients, with a negative predictive value of 98.6% (95% CI 0.98-1.00).<h4>Conclusions</h4>A RSS could be useful in clinical practice to determine which patients with intramucosal PDC have low risk of LNM. |
| format | Article |
| id | doaj-art-2c7fff54e1244973ba16c849be641ec4 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-2c7fff54e1244973ba16c849be641ec42025-08-20T03:11:03ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01115e015620710.1371/journal.pone.0156207A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated-Type Intramucosal Gastric Cancer.Jeung Hui PyoHyuk LeeByung-Hoon MinJun Haeng LeeMin Gew ChoiJun Ho LeeTae Sung SohnJae Moon BaeKyoung-Mee KimHyeon Seon AhnSin-Ho JungSung KimJae J Kim<h4>Background and aim</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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 (<2 points) and 8.9% for high-risk (≥2 points) patients, with a negative predictive value of 98.6% (95% CI 0.98-1.00).<h4>Conclusions</h4>A RSS could be useful in clinical practice to determine which patients with intramucosal PDC have low risk of LNM.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0156207&type=printable |
| spellingShingle | 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 A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated-Type Intramucosal Gastric Cancer. PLoS ONE |
| title | A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated-Type Intramucosal Gastric Cancer. |
| title_full | A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated-Type Intramucosal Gastric Cancer. |
| title_fullStr | A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated-Type Intramucosal Gastric Cancer. |
| title_full_unstemmed | A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated-Type Intramucosal Gastric Cancer. |
| title_short | A Risk Prediction Model Based on Lymph-Node Metastasis in Poorly Differentiated-Type Intramucosal Gastric Cancer. |
| title_sort | risk prediction model based on lymph node metastasis in poorly differentiated type intramucosal gastric cancer |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0156207&type=printable |
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