V.V. Mochalnikova1, A.G. Perevoshchikov1, O.A. Malikhova1,2
1N.N. Blokhin National Medical Research Center of Oncology of the MH of RF, Moscow
2Russian Medical Academy of Continuing Professional Education of the MH of RF, Moscow
Mochalnikova V.V. ― pathologist of the pathoanatomical department of the department of morphological and molecular genetic diagnosis of tumors of N.N. Blokhin National Medical Research Center of Oncology of the MH of RF
23 Kashirskoe highway, Moscow, Russian Federation, 115478, tel. +7-916-640-85-95, e-mail: mochalnikova70@yandex.ru
Abstract
Introduction. The presence of lymphogenic metastatic spreading is a decisive factor for a choice of treatment tactics for patient with early gastric cancer (EGC). Countries of Asian region use endoscopic resection indications proposed by JGCA [1], however, this system does not consider individual clinical data and morphological features of tumor. We have proposed a mathematical model to predict personal risk level of lymphogenic metastatic spreading of early gastric cancer.
Material and methods. We have analyzed surgery material of four hundred and four patients with early gastric cancer, who have undergone radical surgeries in Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation during the period since November 1990 until December 2006. We have measured the level of regional metastatic spreading and tracked 10- and 15-year general and tumor-specific survival rate for all of the cases. We have applied absolute and relative indications for ER of RGC to the general group of patients.
Results. We have performed univariate and multivariate logistic regressive analysis; there have been detected six factors of risk of lymphogenic metastatic spreading of early gastric cancer. There has been created a mathematical model for prediction of individual risk level for lymphogenic metastatic spreading. The percentage of correct (?) was 92.2. Sensitivity, specificity, accuracy, positive prognostic value and negative prognostic value of prediction of lymphogenic metastatic spreading were 79,6%, 89,4%, 88,1%, 53,8% and 96,6% respectively.
Conclusion. Model for prognostication of lymphogenic metastatic spreading of early gastric cancer displayed that predictive result in a group with low risk level of lymphogenic metastatic spreading was better than in a group of patients with ERG, matching the expanded indications JGCA in terms of clinical effectiveness (2.4% vs. 0.8%).
Key words: early gastric cancer, indications for endoscopic resection, metastatic spreading.