Hatta et al developed a simple score for predicting cure after endoscopic submucosal dissection of an early gastric cancer. The authors are from multiple institutions in Japan.
Patient selection: endoscopic submucosal dissection of an early gastric cancer
Parameters:
(1) lymphatic invasion
(2) tumor size in mm
(3) vertical margin
(4) venous invasion
(5) submucosal invasion in microns
Parameter
Finding
Points
lymphatic invasion
absent
0
present
3
tumor size
<= 30 mm
0
> 30 mm
1
vertical margin
negative
0
positive
1
venous invasion
absent
0
present
1
submucosal invasion
< 500 microns
0
>= 500 microns (0.5 mm)
1
where:
• Vertical margin is presumed to be the deep margin.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the risk of lymph node metastases.
Score
Risk Group
Lymph Node Metastases
5-Year Cancer Specific Survival
0 or 1
low
2.5%
99.6%
2 to 4
intermediate
6.7%
96%
5 to 7
high
22.7%
90%
Performance:
• The area under the ROC curve for cancer-specific mortality was 0.78.
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