AUTHOR=Zhang Hao , Wang Chunlin , Liu Yunxiao , Hu Hanqing , Wang Guiyu 

TITLE=A Preoperative Scoring System to Predict the Risk of Inadequate Lymph Node Count in Rectal Cancer

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.938996

DOI=10.3389/fonc.2022.938996

ISSN=2234-943X

ABSTRACT=Purpose: The aim of this study was to develop and validate a preoperative scoring system to stratify rectal cancer (RC) patients with different risk of inadequate lymph node examination.
Methods: A total of 1375 stage I-III RC patients between 2011 and 2020 from the Second Affiliated Hospital of Harbin Medical University were included in the study and randomly divided into development set (n = 688) and validation set (n = 687). Logistic regression model was used to determine independent factors contributing to lymph node count (LNC) < 12. A preoperative scoring system was constructed based on beta () coefficients. The area under the receiver operating curve (AUC) was used to test model discrimination.
Results: Preoperative significant indicators associated with LNC < 12 included age, tumor size, tumor location and CEA. The AUCs of the scoring system for development and validation sets were 0.694 (95%CI = 0.648-0.741) and 0.666 (95%CI = 0.615-0.716), respectively. Patients scored 0-2, 3-4 and 5-6 were classified as low-risk group, medium-risk group and high-risk group.
Conclusions: The preoperative scoring system could identify RC patients with high risk of inadequate lymphadenectomy accurately and further provide a reference to perform preoperative lymph node staining in targeted patients to reduce the difficulty of 12-node standard.