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International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 7/2022

12-04-2022 | Magnetic Resonance Imaging | Original Article

Establishment and validation of a nomogram for predicting potential lateral pelvic lymph node metastasis in low rectal cancer

Authors: Atsuhiko Sumii, Koya Hida, Yoshiharu Sakai, Nobuaki Hoshino, Daisuke Nishizaki, Tomonori Akagi, Meiki Fukuda, Tomohiro Yamaguchi, Ichiro Takemasa, Takuya Tokunaga, Jun Watanabe, Masahiko Watanabe

Published in: International Journal of Clinical Oncology | Issue 7/2022

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Abstract

Background

Identifying lateral pelvic lymph node (LPN) metastasis in low rectal cancer is crucial before treatment. Several risk factors and prediction models for LPN metastasis have been reported. However, there is no useful tool to accurately predict LPN metastasis. Therefore, we aimed to construct a nomogram for predicting LPN metastasis in rectal cancer.

Methods

We analyzed the risk factors for potential LPN metastasis by logistic regression analysis in 705 patients who underwent primary resection of low rectal cancer. We included patients at 49 institutes of the Japan Society of Laparoscopic Colorectal Surgery between June 2010 and February 2012. Clinicopathological factors and magnetic resonance imaging findings were evaluated. The nomogram performance was assessed using the c-index and calibration plots, and the nomogram was validated using an external cohort.

Results

In the univariable logistic regression analysis, age, sex, carcinoembryonic antigen, tumor location, clinical T stage, tumor size, circumferential resection margin (CRM), extramural vascular invasion (EMVI), and the short and long axes of LPN and perirectal lymph node (PRLN) were nominated as risk factors for potential LPN metastasis. We identified a combination of the short axis of LPN, tumor location, EMVI, and short axis of PRLN as optimal for predicting potential LPN metastasis and developed a nomogram using these factors. This model had a c-index of 0.74 and was moderately calibrated and well-validated.

Conclusions

This is the first study to construct a well-validated nomogram for predicting potential LPN metastasis in rectal cancer, and its performance was high.
Appendix
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Metadata
Title
Establishment and validation of a nomogram for predicting potential lateral pelvic lymph node metastasis in low rectal cancer
Authors
Atsuhiko Sumii
Koya Hida
Yoshiharu Sakai
Nobuaki Hoshino
Daisuke Nishizaki
Tomonori Akagi
Meiki Fukuda
Tomohiro Yamaguchi
Ichiro Takemasa
Takuya Tokunaga
Jun Watanabe
Masahiko Watanabe
Publication date
12-04-2022
Publisher
Springer Nature Singapore
Published in
International Journal of Clinical Oncology / Issue 7/2022
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-022-02157-1

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