caa a22 4500 475802136 CHVBK 20180406123740.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1007/s002680010276 doi (NATIONALLICENCE)springer-10.1007/s002680010276 Evaluation of the Maruyama Computer Program Accuracy for Preoperative Estimation of Lymph Node Metastases from Gastric Cancer [Elektronische Daten] [Stefano Guadagni, Giovanni de Manzoni, Marco Catarci, Marco Valenti, Gianfranco Amicucci, Giancarlo De Bernardinis, Claudio Cordiano, Manlio Carboni, Keiichi Maruyama] 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 D2 or more extended LN dissections for gastric cancer. Receiver operating characteristic (ROC) analysis was used to assess the sensitivity and specificity 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 was 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 D3/D4 lymphadenectomies in the historical database may affect the low estimate of metastases to N3/N4 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. Société Internationale de Chirurgie, 2000 Guadagni Stefano Department of Surgery, University of L'Aquila, via Vetoio (Blocco XI), Coppito, 67010 L'Aquila, Italy, IT aut de Manzoni Giovanni First Department of General Surgery, University of Verona, Piazza Stefani 1, 37126 Verona, Italy, IT aut Catarci Marco Second Surgical Clinic, University of Rome "La Sapienza,” viale del Policlinico 155, 00161 Rome, Italy, IT aut Valenti Marco Department of Medical Statistics, University of L'Aquila, via Vetoio (Blocco XI), Coppito, 67010 L'Aquila, Italy, IT aut Amicucci Gianfranco Department of Surgery, University of L'Aquila, via Vetoio (Blocco XI), Coppito, 67010 L'Aquila, Italy, IT aut De Bernardinis Giancarlo Department of Surgery, University of L'Aquila, via Vetoio (Blocco XI), Coppito, 67010 L'Aquila, Italy, IT aut Cordiano Claudio First Department of General Surgery, University of Verona, Piazza Stefani 1, 37126 Verona, Italy, IT aut Carboni Manlio Second Surgical Clinic, University of Rome "La Sapienza,” viale del Policlinico 155, 00161 Rome, Italy, IT aut Maruyama Keiichi Department of Surgical Oncology, National Cancer Center Central Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104, Japan, JP aut World Journal of Surgery Springer-Verlag 24/12(2000-12-01), 1550-1558 0364-2313 24:12<1550 2000 24 268 https://doi.org/10.1007/s002680010276 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010276 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Guadagni Stefano Department of Surgery, University of L'Aquila, via Vetoio (Blocco XI), Coppito, 67010 L'Aquila, Italy, IT aut NATIONALLICENCE 700 1- de Manzoni Giovanni First Department of General Surgery, University of Verona, Piazza Stefani 1, 37126 Verona, Italy, IT aut NATIONALLICENCE 700 1- Catarci Marco Second Surgical Clinic, University of Rome "La Sapienza,” viale del Policlinico 155, 00161 Rome, Italy, IT aut NATIONALLICENCE 700 1- Valenti Marco Department of Medical Statistics, University of L'Aquila, via Vetoio (Blocco XI), Coppito, 67010 L'Aquila, Italy, IT aut NATIONALLICENCE 700 1- Amicucci Gianfranco Department of Surgery, University of L'Aquila, via Vetoio (Blocco XI), Coppito, 67010 L'Aquila, Italy, IT aut NATIONALLICENCE 700 1- De Bernardinis Giancarlo Department of Surgery, University of L'Aquila, via Vetoio (Blocco XI), Coppito, 67010 L'Aquila, Italy, IT aut NATIONALLICENCE 700 1- Cordiano Claudio First Department of General Surgery, University of Verona, Piazza Stefani 1, 37126 Verona, Italy, IT aut NATIONALLICENCE 700 1- Carboni Manlio Second Surgical Clinic, University of Rome "La Sapienza,” viale del Policlinico 155, 00161 Rome, Italy, IT aut NATIONALLICENCE 700 1- Maruyama Keiichi Department of Surgical Oncology, National Cancer Center Central Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104, Japan, JP aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/12(2000-12-01), 1550-1558 0364-2313 24:12<1550 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer