title: Stratifying the risk of lymph node metastasis in undifferentiated-type early gastric cancer.
abstract: OBJECTIVE
  To study how lymph node metastasis (LNM) risk is stratified in undifferentiated-type early gastric cancer (undiff-EGC) dependent on combinations of risk factors.
  
  
  METHODS
  Five hundred and sixty-seven cases with undiff-EGC undergoing gastrectomy with lymphadenectomy were examined retrospectively. Using clinicopathological factors of patient age, location, size, an endoscopic macroscopic tumor form, ulceration, depth, histology, lymphatic involvement (LI) and venous involvement (VI), LNM risk was examined and stratified by conventional statistical analysis and data-mining analysis.
  
  
  RESULTS
  LNM was positive in 44 of 567 cases (7.8%). Univariate analysis revealed > 2 cm, protrusion, submucosal (sm), mixed type, LI and VI as significant prognostic factors and > 2 cm and LI-positive were independent factors by multivariate analysis. In preoperatively evaluable factors excluding LVI, sm and > 2 cm were independent factors. According to the depth and size, cases were categorized into the low-risk group [m and ≤ 2 cm, 0% (LNM incidence)], the moderate-risk group (m and > 2 cm, 5.6%; and sm and ≤ 2 cm, 6.0%), and the high-risk group (sm and > 2 cm, 19.3%). On the other hand, LNM occurred in 1.4% in all LI-negative cases, greatly lower than 28.2% in all LI-positive cases, and LNM incidence was low in LI-negative cases even in the moderate- and high-risk groups.
  
  
  CONCLUSIONS
  LNM-related factors in undiff-EGC were depth and size preoperatively while those were LI and size postoperatively. Among these factors, LI was the most significantly correlated factor.
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Asakawa
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohtaka
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Maekawa
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Fukasawa
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakayama
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Uetake
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakamoto
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Sato
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kawaguchi
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Kunio
authors.initials: K
authors.lastname: Mochizuki
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Hada
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Oyama
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Yasumura
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Kosaku
authors.initials: K
authors.lastname: Omata
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nishiyama
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Naito
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Hata
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Haba
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Miyata
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Saitoh
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Yamadera
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Miura
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kawaoi
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Abe
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Tsunoda
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Honda
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kurosaki
authors.affiliation: Yukiko Asakawa, Masahiko Ohtaka, Shinya Maekawa, Mitsuharu Fukasawa, Yasuhiro Nakayama, Tatsuya Yamaguchi, Taisuke Inoue, Tomoyoshi Uetake, Minoru Sakamoto, Tadashi Sato, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Enomoto
mesh_terms: D000465:Algorithms; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D057225:Data Mining; D003663:Decision Trees; D055088:Early Detection of Cancer; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery
keywords: Data-mining analysis; Lymph node metastasis; Lymphatic involvement; Stratification; Undifferentiated-type early gastric cancer