Tumor volumetry: proposal of a new concept to predict lymph node metastasis in early gastric cancer.
BACKGROUND
The present study was conducted to evaluate the significance of tumor volumetry in early gastric cancer for predicting lymph node metastasis.


METHODS
[corrected] Computer-generated three-dimensional images of tumors from 147 patients with early gastric cancer, who underwent curative gastrectomy with lymphadenectomy, were reconstructed from continuous tissue sections and the volume (mm3) of each tumor was measured by the surface rendering method. Logarithmic tumor volume and conventional pathological factors were then studied with respect to the prevalence of metastasis to regional lymph nodes.


RESULTS
The results of univariate analysis showed that lymph node metastasis was associated with a larger tumor diameter, larger logarithmic tumor volume, a higher rate of blood and lymphatic vessel invasion and a higher incidence of submucosal invasion. However, the results of logistic regression analysis showed that only two factors, logarithmic tumor volume and blood vessel invasion, were independent variables that correlated with lymph node metastasis. Moreover, logarithmic tumor volume was the most important variable correlated with lymph node metastasis in early gastric cancer (p = 0.004, odds ratio: 23.831).


CONCLUSIONS
Based on the present results, tumor volumetry appears to represent a novel method of predicting the likelihood of lymph node metastasis in early gastric cancer.
Department of Surgery, School of Medicine, Kitasato University, 1-15-1, Kitasato, Sagamihara-shi, Kanagawa 228, Japan.
S
S
Kikuchi
S
S
Sakuramoto
N
N
Kobayashi
H
H
Shimao
Y
Y
Sakakibara
K
K
Sato
A
A
Kakita
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010336:Pathology / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013276:Stomach Ulcer / Q000473:pathology; D015996:Survival Rate; D013997:Time Factors