Preoperative predictive model for the probability of lymph node metastasis in gastric cancer: a retrospective study

Abstract

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BackgroundEffectively diagnosing lymph node (LN) metastasis (LNM) is crucial in determining the condition of patients with gastric cancer (GC). The present study was devised to develop and validate a preoperative predictive model (PPM) capable of assessing the LNM status of individuals with GC.MethodsA retrospective analysis of consecutive GC patients from two centers was conducted over the period from January 2021 to December 2023. These patients were utilized to construct a 289-patient training cohort for identifying LNM-related risk factors and developing a PPM, as well as a 90-patient testing cohort used for PPM validation.ResultsOf the GC patients included in the training cohort, 67 (23.2%) and 222 (76.8%) were respectively LNM negative and positive. Risk factors independently related to LNM status included cT3 invasion (P = 0.001), CT-reported LN (+) (P = 0.044), and CA199 value (P = 0.030). LNM risk scores were established with the following formula: score = -2.382 + 0.694×CT-reported LN status (+: 1; -: 0)+2.497×invasion depth (cT1: 0; cT2: 1; cT3: 2)+0.032×CA199 value. The area under the curve (AUC) values for PPM and CT-reported LN status were 0.753 and 0.609, respectively, with a significant difference between them (P < 0.001). When clinical data from the testing cohort was included in the PPM, the AUC values for the PPM and CT-reported LN status were 0.756 and 0.568 (P < 0.001).ConclusionsThe established PPM may be an effective technique for predicting the LNM status of patients preoperatively. This model can better diagnose LNM than CT-reported LN status alone, this model is better able to diagnose LNM.

Keywords

• computed tomography
• lymph node
• metastasis
• gastric cancer
• prediction