Multifocality in early gastric cancer does not increase the risk of lymph node metastasis in a single-center study

Hee Man Kim, Hyun Ki Kim, Sang Kil Lee, Jae Hee Cho, Kyung Ho Pak, Woo Jin Hyung, Sung Hoon Noh, Choong Bai Kim, Yong Chan Lee, Si Young Song, Young Hoon Youn

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Abstract

Background. The multifocality rate of EGC ranges from 4 to 20%, but there are few data regarding both lymph node metastasis and feasibility of the endoscopic treatment. We investigated the risk of lymph node metastasis with the purpose to evaluate the potential for endoscopic treatment in patients with multifocal EGC. Methods. We retrospectively reviewed the medical records of patients who underwent radical gastrectomy to treat EGC between January 2001 and December 2007 at Severance Hospital, Seoul, Korea. Synchronous multifocal EGC was defined as EGC having two or more malignant foci, whereas solitary EGC was defined as EGC having single focus. Results. Of 1,693 patients, 55 (3.2%) were diagnosed with synchronous multifocal EGC. The rates of lymph node metastasis were 12.7% in synchronous multifocal EGC and 10% in solitary EGC. In the multivariate analysis, synchronous multifocal EGC was not associated with lymph node metastasis (odds ratio, 1.1; 95% confidence interval, 0.4-2.7) compared with solitary EGC. In a subgroup analysis of 55 patients with synchronous multifocal EGC, older age (≥65 years) and lymphovascular invasion were associated with lymph node metastasis. In synchronous multifocal EGC, none of the cases had lymph node metastasis in major and minor lesions representing mucosal cancer without lymphovascular invasion. Conclusions. Synchronous multifocality of EGC does not increase the risk of lymph node metastasis compared with solitary EGC. Therefore, endoscopic treatment can be planned when major and minor lesions are predicted to represent mucosal cancer without lymphovascular invasion.

Original languageEnglish
Pages (from-to)1251-1256
Number of pages6
JournalAnnals of Surgical Oncology
Volume19
Issue number4
DOIs
Publication statusPublished - 2012 Apr 1

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Stomach Neoplasms
Lymph Nodes
Neoplasm Metastasis
Gastrectomy
Korea
Medical Records
Neoplasms
Therapeutics
Multivariate Analysis
Odds Ratio
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Kim, Hee Man ; Kim, Hyun Ki ; Lee, Sang Kil ; Cho, Jae Hee ; Pak, Kyung Ho ; Hyung, Woo Jin ; Noh, Sung Hoon ; Kim, Choong Bai ; Lee, Yong Chan ; Song, Si Young ; Youn, Young Hoon. / Multifocality in early gastric cancer does not increase the risk of lymph node metastasis in a single-center study. In: Annals of Surgical Oncology. 2012 ; Vol. 19, No. 4. pp. 1251-1256.
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title = "Multifocality in early gastric cancer does not increase the risk of lymph node metastasis in a single-center study",
abstract = "Background. The multifocality rate of EGC ranges from 4 to 20{\%}, but there are few data regarding both lymph node metastasis and feasibility of the endoscopic treatment. We investigated the risk of lymph node metastasis with the purpose to evaluate the potential for endoscopic treatment in patients with multifocal EGC. Methods. We retrospectively reviewed the medical records of patients who underwent radical gastrectomy to treat EGC between January 2001 and December 2007 at Severance Hospital, Seoul, Korea. Synchronous multifocal EGC was defined as EGC having two or more malignant foci, whereas solitary EGC was defined as EGC having single focus. Results. Of 1,693 patients, 55 (3.2{\%}) were diagnosed with synchronous multifocal EGC. The rates of lymph node metastasis were 12.7{\%} in synchronous multifocal EGC and 10{\%} in solitary EGC. In the multivariate analysis, synchronous multifocal EGC was not associated with lymph node metastasis (odds ratio, 1.1; 95{\%} confidence interval, 0.4-2.7) compared with solitary EGC. In a subgroup analysis of 55 patients with synchronous multifocal EGC, older age (≥65 years) and lymphovascular invasion were associated with lymph node metastasis. In synchronous multifocal EGC, none of the cases had lymph node metastasis in major and minor lesions representing mucosal cancer without lymphovascular invasion. Conclusions. Synchronous multifocality of EGC does not increase the risk of lymph node metastasis compared with solitary EGC. Therefore, endoscopic treatment can be planned when major and minor lesions are predicted to represent mucosal cancer without lymphovascular invasion.",
author = "Kim, {Hee Man} and Kim, {Hyun Ki} and Lee, {Sang Kil} and Cho, {Jae Hee} and Pak, {Kyung Ho} and Hyung, {Woo Jin} and Noh, {Sung Hoon} and Kim, {Choong Bai} and Lee, {Yong Chan} and Song, {Si Young} and Youn, {Young Hoon}",
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Multifocality in early gastric cancer does not increase the risk of lymph node metastasis in a single-center study. / Kim, Hee Man; Kim, Hyun Ki; Lee, Sang Kil; Cho, Jae Hee; Pak, Kyung Ho; Hyung, Woo Jin; Noh, Sung Hoon; Kim, Choong Bai; Lee, Yong Chan; Song, Si Young; Youn, Young Hoon.

In: Annals of Surgical Oncology, Vol. 19, No. 4, 01.04.2012, p. 1251-1256.

Research output: Contribution to journalArticle

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T1 - Multifocality in early gastric cancer does not increase the risk of lymph node metastasis in a single-center study

AU - Kim, Hee Man

AU - Kim, Hyun Ki

AU - Lee, Sang Kil

AU - Cho, Jae Hee

AU - Pak, Kyung Ho

AU - Hyung, Woo Jin

AU - Noh, Sung Hoon

AU - Kim, Choong Bai

AU - Lee, Yong Chan

AU - Song, Si Young

AU - Youn, Young Hoon

PY - 2012/4/1

Y1 - 2012/4/1

N2 - Background. The multifocality rate of EGC ranges from 4 to 20%, but there are few data regarding both lymph node metastasis and feasibility of the endoscopic treatment. We investigated the risk of lymph node metastasis with the purpose to evaluate the potential for endoscopic treatment in patients with multifocal EGC. Methods. We retrospectively reviewed the medical records of patients who underwent radical gastrectomy to treat EGC between January 2001 and December 2007 at Severance Hospital, Seoul, Korea. Synchronous multifocal EGC was defined as EGC having two or more malignant foci, whereas solitary EGC was defined as EGC having single focus. Results. Of 1,693 patients, 55 (3.2%) were diagnosed with synchronous multifocal EGC. The rates of lymph node metastasis were 12.7% in synchronous multifocal EGC and 10% in solitary EGC. In the multivariate analysis, synchronous multifocal EGC was not associated with lymph node metastasis (odds ratio, 1.1; 95% confidence interval, 0.4-2.7) compared with solitary EGC. In a subgroup analysis of 55 patients with synchronous multifocal EGC, older age (≥65 years) and lymphovascular invasion were associated with lymph node metastasis. In synchronous multifocal EGC, none of the cases had lymph node metastasis in major and minor lesions representing mucosal cancer without lymphovascular invasion. Conclusions. Synchronous multifocality of EGC does not increase the risk of lymph node metastasis compared with solitary EGC. Therefore, endoscopic treatment can be planned when major and minor lesions are predicted to represent mucosal cancer without lymphovascular invasion.

AB - Background. The multifocality rate of EGC ranges from 4 to 20%, but there are few data regarding both lymph node metastasis and feasibility of the endoscopic treatment. We investigated the risk of lymph node metastasis with the purpose to evaluate the potential for endoscopic treatment in patients with multifocal EGC. Methods. We retrospectively reviewed the medical records of patients who underwent radical gastrectomy to treat EGC between January 2001 and December 2007 at Severance Hospital, Seoul, Korea. Synchronous multifocal EGC was defined as EGC having two or more malignant foci, whereas solitary EGC was defined as EGC having single focus. Results. Of 1,693 patients, 55 (3.2%) were diagnosed with synchronous multifocal EGC. The rates of lymph node metastasis were 12.7% in synchronous multifocal EGC and 10% in solitary EGC. In the multivariate analysis, synchronous multifocal EGC was not associated with lymph node metastasis (odds ratio, 1.1; 95% confidence interval, 0.4-2.7) compared with solitary EGC. In a subgroup analysis of 55 patients with synchronous multifocal EGC, older age (≥65 years) and lymphovascular invasion were associated with lymph node metastasis. In synchronous multifocal EGC, none of the cases had lymph node metastasis in major and minor lesions representing mucosal cancer without lymphovascular invasion. Conclusions. Synchronous multifocality of EGC does not increase the risk of lymph node metastasis compared with solitary EGC. Therefore, endoscopic treatment can be planned when major and minor lesions are predicted to represent mucosal cancer without lymphovascular invasion.

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