{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:59:04Z","timestamp":1793303944436,"version":"4.5.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"Fujian Medical University Startup Grant","award":["No. 2023QH1116"],"award-info":[{"award-number":["No. 2023QH1116"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Updates Surg"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1007\/s13304-025-02471-z","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T17:24:10Z","timestamp":1765301050000},"page":"1061-1073","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A machine learning-based predictive model for lymph node metastasis in elderly patients with early gastric cancer and prognosis"],"prefix":"10.1007","volume":"78","author":[{"given":"Huida","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoyi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjin","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wengui","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuying","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5147-292X","authenticated-orcid":false,"given":"Jianhua","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"issue":"3","key":"2471_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209\u2013249. https:\/\/doi.org\/10.3322\/caac.21660","journal-title":"CA Cancer J Clin"},{"issue":"2","key":"2471_CR2","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1007\/s10120-011-0041-5","volume":"14","author":"Japanese Gastric Cancer Association","year":"2011","unstructured":"Japanese Gastric Cancer Association (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 14(2):101\u2013112. https:\/\/doi.org\/10.1007\/s10120-011-0041-5","journal-title":"Gastric Cancer"},{"issue":"2","key":"2471_CR3","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.cgh.2022.07.029","volume":"21","author":"H Suzuki","year":"2023","unstructured":"Suzuki H, Ono H, Hirasawa T et al (2023) Long-term survival after endoscopic resection for gastric cancer: real-world evidence from a multicenter prospective cohort. Clin Gastroenterol Hepatol 21(2):307-318.e2. https:\/\/doi.org\/10.1016\/j.cgh.2022.07.029","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"11","key":"2471_CR4","doi-asserted-by":"publisher","first-page":"3677","DOI":"10.1245\/s10434-016-5279-z","volume":"23","author":"N Chapelle","year":"2016","unstructured":"Chapelle N, Bouvier AM, Manfredi S et al (2016) EGC: trends in incidence, management, and survival in a well-defined french population. Ann Surg Oncol 23(11):3677\u20133683. https:\/\/doi.org\/10.1245\/s10434-016-5279-z","journal-title":"Ann Surg Oncol"},{"issue":"5","key":"2471_CR5","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1001\/jamasurg.2022.0182","volume":"157","author":"GZ Li","year":"2022","unstructured":"Li GZ, Doherty GM, Wang J (2022) Surgical management of gastric cancer: a review. JAMA Surg 157(5):446\u2013454. https:\/\/doi.org\/10.1001\/jamasurg.2022.0182","journal-title":"JAMA Surg"},{"issue":"6","key":"2471_CR6","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1016\/j.surg.2021.12.015","volume":"171","author":"H Zhu","year":"2022","unstructured":"Zhu H, Wang G, Zheng J et al (2022) Preoperative prediction for LNM in EGCby interpretable ML models: a multicenter study. Surgery 171(6):1543\u20131551. https:\/\/doi.org\/10.1016\/j.surg.2021.12.015","journal-title":"Surgery"},{"issue":"9","key":"2471_CR7","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1055\/s-0034-1392882","volume":"47","author":"P Pimentel-Nunes","year":"2015","unstructured":"Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T et al (2015) Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 47(9):829\u2013854. https:\/\/doi.org\/10.1055\/s-0034-1392882","journal-title":"Endoscopy"},{"issue":"3","key":"2471_CR8","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1111\/den.14105","volume":"34","author":"Y Kishida","year":"2022","unstructured":"Kishida Y, Takizawa K, Kakushima N et al (2022) Endoscopic submucosal dissection versus surgery in elderly patients with EGCof relative indication for endoscopic resection. Dig Endosc 34(3):497\u2013507. https:\/\/doi.org\/10.1111\/den.14105","journal-title":"Dig Endosc"},{"issue":"5","key":"2471_CR9","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1016\/j.gie.2021.12.028","volume":"95","author":"K Waki","year":"2022","unstructured":"Waki K, Shichijo S, Uedo N et al (2022) Long-term outcomes after endoscopic resection for late-elderly patients with EGC. Gastrointest Endosc 95(5):873\u2013883. https:\/\/doi.org\/10.1016\/j.gie.2021.12.028","journal-title":"Gastrointest Endosc"},{"key":"2471_CR10","doi-asserted-by":"publisher","first-page":"e0144774","DOI":"10.1371\/journal.pone.0144774.]","volume":"10","author":"S Wang","year":"2015","unstructured":"Wang S, Zhang Z, Liu M, Li S, Jiang C (2015) Endoscopic resection compared with gastrectomy to treat early gastric cancer: a systematic review and meta-analysis. PLoS ONE 10:e0144774. https:\/\/doi.org\/10.1371\/journal.pone.0144774.]","journal-title":"PLoS ONE"},{"issue":"6","key":"2471_CR11","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1055\/a-1117-3059DOI:10.1055\/a-1117-3059","volume":"52","author":"SM Kim","year":"2020","unstructured":"Kim SM, Min BH, Ahn JH et al (2020) Nomogram to predict LNM in patients with EGC: a useful clinical tool to reduce gastrectomy after endoscopic resection. Endoscopy 52(6):435\u2013443. https:\/\/doi.org\/10.1055\/a-1117-3059DOI:10.1055\/a-1117-3059","journal-title":"Endoscopy"},{"key":"2471_CR12","doi-asserted-by":"publisher","unstructured":"Yin XY, Pang T, Liu Y, et al. (2020) Development and validation of a nomogram for preoperative prediction of LNM in EGC. World J Surg Oncol. 18(1):2. Published 2020 Jan 2. https:\/\/doi.org\/10.1186\/s12957-019-1778-2","DOI":"10.1186\/s12957-019-1778-2"},{"key":"2471_CR13","doi-asserted-by":"publisher","first-page":"3807","DOI":"10.3748\/wjg.v29.i24.3807]","volume":"29","author":"JJ Yang","year":"2023","unstructured":"Yang JJ, Wang XY, Ma R, Chen MH, Zhang GX, Li X (2023) Prediction of lymph node metastasis in early gastric signet-ring cell carcinoma: a real-world retrospective cohort study. World J Gastroenterol 29:3807\u20133824. https:\/\/doi.org\/10.3748\/wjg.v29.i24.3807]","journal-title":"World J Gastroenterol"},{"key":"2471_CR14","doi-asserted-by":"publisher","first-page":"A1","DOI":"10.1016\/j.mri.2019.12.006","volume":"68","author":"JC Gore","year":"2020","unstructured":"Gore JC (2020) Artificial intelligence in medical imaging. Magn Reson Imaging 68:A1\u2013A4. https:\/\/doi.org\/10.1016\/j.mri.2019.12.006","journal-title":"Magn Reson Imaging"},{"key":"2471_CR15","doi-asserted-by":"publisher","first-page":"984750","DOI":"10.3389\/fpubh.2022.984750.]","volume":"10","author":"T Li","year":"2022","unstructured":"Li T, Huang H, Zhang S, Zhang Y, Jing H, Sun T, Zhang X, Lu L, Zhang M (2022) Predictive models based on machine learning for bone metastasis in patients with diagnosed colorectal cancer. Front Public Health 10:984750. https:\/\/doi.org\/10.3389\/fpubh.2022.984750.]","journal-title":"Front Public Health"},{"key":"2471_CR16","doi-asserted-by":"publisher","first-page":"807382","DOI":"10.3389\/fmed.2022.807382.]","volume":"9","author":"W Li","year":"2022","unstructured":"Li W, Hong T, Liu W, Dong S, Wang H, Tang ZR, Li W, Wang B, Hu Z, Liu Q, Qin Y, Yin C (2022) Development of a machine learning-based predictive model for lung metastasis in patients with ewing sarcoma. Front Med (Lausanne) 9:807382. https:\/\/doi.org\/10.3389\/fmed.2022.807382.]","journal-title":"Front Med (Lausanne)"},{"key":"2471_CR17","doi-asserted-by":"publisher","first-page":"8759","DOI":"10.1007\/s00432-023-04816-w.]","volume":"149","author":"X Wang","year":"2023","unstructured":"Wang X, Zhang X, Li H, Zhang M, Liu Y, Li X (2023) Application of machine learning algorithm in prediction of lymph node metastasis in patients with intermediate and high-risk prostate cancer. J Cancer Res Clin Oncol 149:8759\u20138768. https:\/\/doi.org\/10.1007\/s00432-023-04816-w.]","journal-title":"J Cancer Res Clin Oncol"},{"key":"2471_CR18","doi-asserted-by":"publisher","first-page":"1235121","DOI":"10.3389\/fonc.2023.1235121.]","volume":"13","author":"B Qiu","year":"2023","unstructured":"Qiu B, Shen Z, Wu S, Qin X, Yang D, Wang Q (2023) A machine learning-based model for predicting distant metastasis in patients with rectal cancer. Front Oncol 13:1235121. https:\/\/doi.org\/10.3389\/fonc.2023.1235121.]","journal-title":"Front Oncol"},{"key":"2471_CR19","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2021.104813","volume":"137","author":"K Wang","year":"2021","unstructured":"Wang K, Tian J, Zheng C et al (2021) Interpretable prediction of 3-year all-cause mortality in patients with heart failure caused by coronary heart disease based on ML and SHAP. Comput Biol Med 137:104813. https:\/\/doi.org\/10.1016\/j.compbiomed.2021.104813","journal-title":"Comput Biol Med"},{"key":"2471_CR20","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1016\/S0140-6736(20)31288-5","volume":"396","author":"EC Smyth","year":"2020","unstructured":"Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F (2020) Gastric cancer. Lancet 396:635\u2013648. https:\/\/doi.org\/10.1016\/S0140-6736(20)31288-5","journal-title":"Lancet"},{"issue":"1","key":"2471_CR21","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-02305-z","volume":"11","author":"M Zhang","year":"2021","unstructured":"Zhang M, Ding C, Xu L, Feng S, Ling Y, Guo J, Liang Y, Zhou Z, Chen Y, Qiu H (2021) A nomogram to predict risk of lymph node metastasis in early gastric cancer. Sci Rep 11(1):22873. https:\/\/doi.org\/10.1038\/s41598-021-02305-z","journal-title":"Sci Rep"},{"key":"2471_CR22","doi-asserted-by":"publisher","first-page":"13842","DOI":"10.3748\/wjg.v20.i38.13842","volume":"20","author":"V Pasechnikov","year":"2014","unstructured":"Pasechnikov V, Chukov S, Fedorov E, Kikuste I, Leja M (2014) Gastric cancer: prevention, screening and early diagnosis. World J Gastroenterol 20:13842\u201313862","journal-title":"World J Gastroenterol"},{"issue":"Suppl 1","key":"2471_CR23","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s10120-016-0659-4","volume":"20","author":"K Sumiyama","year":"2017","unstructured":"Sumiyama K (2017) Past and current trends in endoscopic diagnosis for early stage gastric cancer in Japan [published correction appears in Gastric Cancer. 2017 May;20(3):562]. Gastric Cancer 20(Suppl 1):20\u201327. https:\/\/doi.org\/10.1007\/s10120-016-0659-4","journal-title":"Gastric Cancer"},{"issue":"1","key":"2471_CR24","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/den.13883","volume":"33","author":"H Ono","year":"2021","unstructured":"Ono H, Yao K, Fujishiro M et al (2021) Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for EGC(second edition). Dig Endosc 33(1):4\u201320. https:\/\/doi.org\/10.1111\/den.13883","journal-title":"Dig Endosc"},{"issue":"3","key":"2471_CR25","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.gie.2023.03.030","volume":"98","author":"MA Al-Haddad","year":"2023","unstructured":"Al-Haddad MA, Elhanafi SE, Forbes N et al (2023) American Society for Gastrointestinal Endoscopy guideline on endoscopic submucosal dissection for the management of early esophageal and gastric cancers: methodology and review of evidence. Gastrointest Endosc 98(3):285-305.e38. https:\/\/doi.org\/10.1016\/j.gie.2023.03.030","journal-title":"Gastrointest Endosc"},{"issue":"9","key":"2471_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/gutjnl-2019-319646","volume":"69","author":"N Shahidi","year":"2020","unstructured":"Shahidi N, Bourke MJ (2020) ESD, not EMR, should be the first-line therapy for early gastric neoplasia. Gut 69(9):1\u20132. https:\/\/doi.org\/10.1136\/gutjnl-2019-319646","journal-title":"Gut"},{"issue":"Suppl 3","key":"2471_CR27","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1111\/j.1440-1746.2012.07075.x","volume":"27","author":"S Tokioka","year":"2012","unstructured":"Tokioka S, Umegaki E, Murano M et al (2012) Utility and problems of endoscopic submucosal dissection for EGCin elderly patients. J Gastroenterol Hepatol 27(Suppl 3):63\u201369. https:\/\/doi.org\/10.1111\/j.1440-1746.2012.07075.x","journal-title":"J Gastroenterol Hepatol"},{"issue":"4","key":"2471_CR28","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.gie.2014.04.042","volume":"80","author":"CH Park","year":"2014","unstructured":"Park CH, Lee H, Kim DW et al (2014) Clinical safety of endoscopic submucosal dissection compared with surgery in elderly patients with EGC: a propensity-matched analysis. Gastrointest Endosc 80(4):599\u2013609. https:\/\/doi.org\/10.1016\/j.gie.2014.04.042","journal-title":"Gastrointest Endosc"},{"issue":"1","key":"2471_CR29","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/s00795-010-0503-6","volume":"44","author":"Y Akashi","year":"2011","unstructured":"Akashi Y, Noguchi T, Nagai K, Kawahara K, Shimada T (2011) Cytoarchitecture of the lamina muscularis mucosae and distribution of the lymphatic vessels in the human stomach. Med Mol Morphol 44(1):39\u201345. https:\/\/doi.org\/10.1007\/s00795-010-0503-6","journal-title":"Med Mol Morphol"},{"issue":"2","key":"2471_CR30","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1245\/s10434-016-5494-7","volume":"24","author":"J Lu","year":"2017","unstructured":"Lu J, Wang W, Zheng CH et al (2017) Influence of total lymph node count on staging and survival after gastrectomy for gastric cancer: an analysis from a two-institution database in China. Ann Surg Oncol 24(2):486\u2013493. https:\/\/doi.org\/10.1245\/s10434-016-5494-7","journal-title":"Ann Surg Oncol"},{"issue":"9","key":"2471_CR31","doi-asserted-by":"publisher","first-page":"1566","DOI":"10.1111\/jgh.13306","volume":"31","author":"W Okajima","year":"2016","unstructured":"Okajima W, Komatsu S, Ichikawa D et al (2016) Prognostic impact of the number of retrieved lymph nodes in patients with gastric cancer. J Gastroenterol Hepatol 31(9):1566\u20131571. https:\/\/doi.org\/10.1111\/jgh.13306","journal-title":"J Gastroenterol Hepatol"},{"key":"2471_CR32","doi-asserted-by":"publisher","first-page":"3683","DOI":"10.1245\/s10434-017-6078-x","volume":"24","author":"H In","year":"2017","unstructured":"In H, Solsky I, Palis B, Langdon-Embry M, Ajani J, Sano T (2017) Validation of the 8th edition of the AJCC TNM staging system for gastric cancer using the National Cancer Database. Ann Surg Oncol 24:3683\u20133691. https:\/\/doi.org\/10.1245\/s10434-017-6078-x","journal-title":"Ann Surg Oncol"},{"issue":"4","key":"2471_CR33","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1002\/jso.20566","volume":"94","author":"F Roviello","year":"2006","unstructured":"Roviello F, Rossi S, Marrelli D et al (2006) Number of lymph node metastases and its prognostic significance in EGC: a multicenter Italian study. J Surg Oncol 94(4):275\u2013274. https:\/\/doi.org\/10.1002\/jso.20566","journal-title":"J Surg Oncol"},{"key":"2471_CR34","doi-asserted-by":"publisher","unstructured":"Li J, Cui T, Huang Z, et al. (2023) Analysis of risk factors for LNM and prognosis study in patients with EGC: A SEER data-based study. Front Oncol. 13:1062142. Published 2023 Mar 17. https:\/\/doi.org\/10.3389\/fonc.2023.1062142","DOI":"10.3389\/fonc.2023.1062142"},{"key":"2471_CR35","doi-asserted-by":"publisher","unstructured":"Okagawa Y, Sumiyoshi T, Kondo H, et al. (2021) Comparison of clinicopathological features and long-term prognosis between mixed predominantly differentiated-type and pure differentiated-type EGC. BMC Cancer. 21(1):235. Published 2021 Mar 6. https:\/\/doi.org\/10.1186\/s12885-021-07962-x","DOI":"10.1186\/s12885-021-07962-x"},{"key":"2471_CR36","doi-asserted-by":"publisher","unstructured":"Tian H, Ning Z, Zong Z, et al. (2022) Application of ML Algorithms to Predict LNM in EGC. Front Med (Lausanne) 8:759013. Published 2022 Jan 18. https:\/\/doi.org\/10.3389\/fmed.2021.759013","DOI":"10.3389\/fmed.2021.759013"}],"container-title":["Updates in Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13304-025-02471-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13304-025-02471-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13304-025-02471-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:37:15Z","timestamp":1780983435000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13304-025-02471-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,9]]},"references-count":36,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["2471"],"URL":"https:\/\/doi.org\/10.1007\/s13304-025-02471-z","relation":{},"ISSN":["2038-131X","2038-3312"],"issn-type":[{"value":"2038-131X","type":"print"},{"value":"2038-3312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,9]]},"assertion":[{"value":"28 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflict of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Ethics Committee of the Second Affiliated Hospital of Fujian Medical University (2025\u2013604).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"As this was a retrospective study, no written informed consent was required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}