193 MET and nodal metastasis Table 1: presentation of pathological lymph node groups (pN) with respect to clinical lymph node groups (cN). cN Total N0 N+ pN N0 70 2 72 N+ 20 10 30 Total 90 12 102 ROC curve analyses showed that MET positivity is associated with pN+ and occult LNM and that DOI > 4 mm has a higher sensitivity for pN+ and occult LNM compared to MET positivity (Figure 2, Supplementary figure 1). Figure 2: ROC curve indicating the area under the curve for A. MET positivity and B. Depth of invasion set at > 4 mm and LNM (cN0 and cN+/pN+). Forty-five (44.1%) of the included cancers were positive for MET (Table 2). Seventy-five cancers (73.5%) had a DOI > 4 mm (Table 3). The positive predictive value (PPV) for MET positivity was 44.4%, for DOI > 4 mm 33.3% (Table 4). The NPV for MET positivity was 82.5%, for DOI > 4 mm 81.5% (Table 4). Within the cN0 group (n=90), 38 cancers were positive for MET (42.2%) (Table 2) and 52 had a DOI > 4 mm (57.8%) (Table 3). For this cN0 group, the PPV for MET positivity was 36.8%, for DOI > 4 mm 25.8%; the NPV for MET positivity was 88.5% and for DOI > 4 mm 87.5% (Table 4). 6

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