Preoperative prediction of lymph node status in gastric cancer patients with the help of computer analysis.
BACKGROUND
An optimal management of gastric cancer should be stage-oriented with the main criterion of lymph node status. Nodal status can be assessed preoperatively with modern radiological imaging techniques, sentinel node biopsy, molecular or genetic markers of tumor and computer analysis. The aim of this study was to evaluate the feasibility and accuracy in preoperative prediction of lymph node status with the help of computer analysis.


METHODS
The computer model was constructed with data from patients with gastric cancer treated at the University Medical Centre Ljubljana between 1993 and 2003. Prediction of the computer model was then tested on 110 patients treated between 2004 and 2005 in the same manner as patients from the database. The goal of the study was to compare prediction for lymph node status in the control group by the computer program with real data collected after surgery.


RESULTS
Accuracy of computerized preoperative predictions of N0/N1 status is 86% (sensitivity 91% and specificity 79%) and of N1/N2 status is 89% (sensitivity 87% and specificity 90%).


CONCLUSIONS
Results of accuracy of preoperative predictions of nodal status are very high and allow in each individual case to guide stage-appropriate therapy. Best applicability is obtained with implementation of this new approach with standard diagnostic methods.
Mekicar
Jernej
J
Department of Abdominal Surgery, University Medical Centre Ljubljana, Zaloska 7, Ljubljana, Slovenia. jernej.mekicar@kclj.si
Omejc
Mirko
M
D003936:Diagnosis, Computer-Assisted; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome