Sekiguchi et al reported a score for predicting lymph node metastasis in patients with early gastric cancer. This can help to identify a patient who may benefit from adjuvant chemotherapy. The authors are from the National Cancer Center Hospital in Tokyo and Shiga University.
Patient selection: early gastric cancer (mucosa or submucosa)
Outcome: lymph node metastases
Parameters:
(1) tumor size in cm
(2) invasion depth
(3) histological type
(4) ulceration
(5) lymphovascular invasion
Parameter
Finding
Points
tumor size
<= 2 cm
0
2.01 to 3.0 cm
1
> 3 cm
2
depth
mucosa (within muscularis mucosae)
0
submucosal layer < 500 µm from muscularis mucosae
0
submucosal layer >= 500 µm from the muscularis mucosae
2
histological type
pure differentiated
0
pure undifferentiated
1
mixed, differentiated predominant
1
mixed, undifferentiated predominant
2
ulceration
no
0
yes
1
lymphovascular invasion
no
0
yes
4
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
Risk Score
Positive Lymph Node
0 or 1
< 1%
2
2%
3
4%
4
8%
5
7-13%
6
17-22%
7
26-30%
8
15-34%
9
28-49%
10
50-56%
11
65-80%
Performance:
• The area under the ROC curve is 0.84.
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