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Titolo:
Evaluation of the maruyama computer program accuracy for preoperative estimation of lymph node metastases from gastric cancer
Autore:
Guadagni, S; de Manzoni, G; Catarci, M; Valenti, M; Amicucci, G; De Bernardinis, G; Cordiano, C; Carboni, M; Maruyama, K;
Indirizzi:
Univ Aquila, Dept Surg, I-67010 Coppito, Laquila, Italy Univ Aquila Coppito Laquila Italy I-67010 I-67010 Coppito, Laquila, Italy Univ Verona, Dept Gen Surg 1, I-37126 Verona, Italy Univ Verona Verona Italy I-37126 Dept Gen Surg 1, I-37126 Verona, Italy Univ Rome La Sapienza, Surg Clin 2, I-00161 Rome, Italy Univ Rome La Sapienza Rome Italy I-00161 urg Clin 2, I-00161 Rome, Italy Univ Aquila, Dept Med Stat, I-67010 Coppito, Laquila, Italy Univ Aquila Coppito Laquila Italy I-67010 I-67010 Coppito, Laquila, Italy Cent Hosp, Natl Canc Ctr, Dept Surg Oncol, Chuo Ku, Tokyo 104, Japan Cent Hosp Tokyo Japan 104 tr, Dept Surg Oncol, Chuo Ku, Tokyo 104, Japan
Titolo Testata:
WORLD JOURNAL OF SURGERY
fascicolo: 12, volume: 24, anno: 2000,
pagine: 1550 - 1558
SICI:
0364-2313(200012)24:12<1550:EOTMCP>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
D-2 RESECTIONS; SURGICAL TRIAL; DISSECTION; CARCINOMA; SURVIVAL; LYMPHADENECTOMY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Guadagni, S Univ Aquila, Dept Surg, Via Vetoio Blocco 11, I-67010 Coppito,Laquila, Italy Univ Aquila Via Vetoio Blocco 11 Coppito Laquila Italy I-67010
Citazione:
S. Guadagni et al., "Evaluation of the maruyama computer program accuracy for preoperative estimation of lymph node metastases from gastric cancer", WORLD J SUR, 24(12), 2000, pp. 1550-1558

Abstract

Controversy still exists about the optimal lymph node (LN) dissection for potentially curable gastric cancer. For rational LN dissection it is important to know the incidence of metastasis at each LN station. For this purpose a computer program was developed using data from 4302 primary gastric cancers treated at the National Cancer Center Hospital in Tokyo between 1969 and 1989. To evaluate the accuracy of the computer program, the differences between the individual reports generated by the computer and the stored data were investigated in 282 Italian patients submitted to curative gastrectomy and D-2 or more extended LN dissections for gastric cancer. Receiver operating characteristic (ROC) analysis was used to assess the sensitivity andspecificity of the program for predicting LN metastases in each of the 16 regional LN stations. The computer program showed good predictive ability for LN metastases in most of the 16 LN stations, as the areas under the curve ranged from 0.741 (station 15) to 0.944 (station 8), with a mean of 0.856. A critical cutoff point of 18% of the program's expected percentage was the value maximizing the validity of the prediction. Using an "absolute" cutoff point of 0% the overall rate of false-negative (FN) predictions in 176 N+ patients nas 11.9%; of these, 11 (6.2%) were absolute FNs, in which the program totally failed to estimate LN metastases; the remaining 10 cases (5.7%) were relative FNs because the specific prediction was positive for a different depth of stomach invasion. The low number of D-3/D-4 lymphadenectomies in the historical database may affect the low estimate of metastases to N-3/N-4 nodes generated by the program, Based on these data, the program predicts with good accuracy the extent of LN metastases from gastric cancer, but it is not recommended for directing the surgeon to perform more extensive lymphadenectomy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/09/20 alle ore 23:28:15