Research Papers:

Measurement of tumor volume is not superior to diameter for prediction of lymph node metastasis in early gastric cancer with minute submucosal invasion

Jeung Hui Pyo, Sun-Ju Byeon, Hyuk Lee _, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Kyoung-Mee Kim, Hyeon Seon Ahn, Kyunga Kim, Yoon-Ho Choi and Jae J. Kim

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Oncotarget. 2017; 8:113758-113765. https://doi.org/10.18632/oncotarget.22894

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Jeung Hui Pyo1,*, Sun-Ju Byeon2,*, Hyuk Lee3, Yang Won Min3, Byung-Hoon Min3, Jun Haeng Lee3, Kyoung-Mee Kim2, Hyeon Seon Ahn4, Kyunga Kim4, Yoon-Ho Choi1 and Jae J. Kim2

1Center for Health Promotion, Samsung Medical Center, Seoul, Korea

2Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

3Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

4Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea

*These authors contributed equally to this work

Correspondence to:

Hyuk Lee, email: [email protected]

Keywords: tumor diameter; tumor volume; lymph node metastasis; early gastric cancer; endoscopic resection

Received: August 23, 2017     Accepted: November 13, 2017     Published: December 04, 2017


Background/Aim: The current indication for endoscopic resection in early gastric cancer (EGC) with minute (< 500 μm) submucosal invasion is based on tumor diameter, which may be insufficient to predict lymph node metastasis (LNM). We investigated whether tumor volume might more accurately predict LNM in EGC with minute submucosal invasion.

Materials and Methods: Among patients who underwent gastrectomy for gastric cancer, 346 with well/moderately differentiated EGC with submucosal invasion <500 μm were evaluated. Three-dimensional tumor volume was calculated using an endoscopically resected specimen and compared with 1-dimensional tumor diameter. Predictive ability of tumor diameter or volume for LNM was evaluated using receiver operating characteristic curve analysis.

Results: Tumor diameter and volume predicted LNM with an area under the curve (AUC) of 0.567 and 0.589, respectively. AUC, sensitivity, specificity, positive and negative predictive values, and accuracy of the 2 models were not significantly different. Tumor diameter ≥ 3 cm showed a significant association with LNM (odds ratio [OR], 2.57; 95% confidence interval [CI], 1.01–6.57; P = 0.049), whereas a tumor volume cutoff value of 752.8 cm3 showed no significant association with LNM (OR, 1.52; 95% CI, 0.59–3.88; P = 0.385).

Conclusions: Tumor volume had no advantage over diameter for predicting LNM in well/moderately differentiated EGC with minute submucosal invasion.

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