Poorly Differentiated Carcinoma Component in Submucosal Layer Should be Considered as an Additional Criterion for Curative Endoscopic Resection of Early Gastric Cancer

Da Hyun Jung, Yoon Sung Bae, Sun Och Yoon, Yong Chan Lee, Hoguen Kim, Sung Hoon Noh, Hyojin Park, Seung Ho Choi, Jie Hyun Kim, Hyunki Kim

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Some studies have reported lymph node metastasis (LNM) in early gastric cancer (EGC) cases meeting the expanded criteria for endoscopic resection. Therefore, we investigated whether a minor poorly differentiated carcinoma (PDC) component in the submucosal (SM) layer affects LNM in differentiated EGC. Methods: We performed surgery in 1096 patients with differentiated SM gastric cancer and compared the clinicopathologic features of node-positive (n = 194) and node-negative (n = 902) differentiated SM cancer, with special reference to the portion of PDC component in the SM layer. Results: When we categorized patients by the proportion of PDC component in the SM layer, we found 840 patients had <5 % and 256 patients had ≥5 % PDC components in the SM layer. The ≥5 % group was significantly associated with younger age, female sex, moderate differentiation, deep SM invasion, lymphovascular invasion (LVI), perineural invasion, and LNM. In multivariate analysis, middle third location, moderate differentiation, SM2 invasion, size >2 cm, LVI, and PDC components in the SM layer were independent risk factors for LNM. When we limited the depth of invasion to SM1, the incidence of LNM was significantly higher in the ≥5 % group. On multivariate analysis, tumor size >2 cm, moderate differentiation, LVI positivity, and ≥5 % PDC components in the SM1 layer were independent risk factors for LNM in SM1 cancer. Conclusions: The PDC component in the SM layer of differentiated EGC was an independent risk factor of LNM, which might constitute a supplementary criterion in the expanded indications for endoscopic resection in differentiated EGC.

Original languageEnglish
Pages (from-to)772-777
Number of pages6
JournalAnnals of Surgical Oncology
Volume22
DOIs
Publication statusPublished - 2015 Dec 1

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Stomach Neoplasms
Lymph Nodes
Neoplasm Metastasis
Carcinoma
Neoplasms
Multivariate Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

@article{447882e0ab924708abc490634080f618,
title = "Poorly Differentiated Carcinoma Component in Submucosal Layer Should be Considered as an Additional Criterion for Curative Endoscopic Resection of Early Gastric Cancer",
abstract = "Background: Some studies have reported lymph node metastasis (LNM) in early gastric cancer (EGC) cases meeting the expanded criteria for endoscopic resection. Therefore, we investigated whether a minor poorly differentiated carcinoma (PDC) component in the submucosal (SM) layer affects LNM in differentiated EGC. Methods: We performed surgery in 1096 patients with differentiated SM gastric cancer and compared the clinicopathologic features of node-positive (n = 194) and node-negative (n = 902) differentiated SM cancer, with special reference to the portion of PDC component in the SM layer. Results: When we categorized patients by the proportion of PDC component in the SM layer, we found 840 patients had <5 {\%} and 256 patients had ≥5 {\%} PDC components in the SM layer. The ≥5 {\%} group was significantly associated with younger age, female sex, moderate differentiation, deep SM invasion, lymphovascular invasion (LVI), perineural invasion, and LNM. In multivariate analysis, middle third location, moderate differentiation, SM2 invasion, size >2 cm, LVI, and PDC components in the SM layer were independent risk factors for LNM. When we limited the depth of invasion to SM1, the incidence of LNM was significantly higher in the ≥5 {\%} group. On multivariate analysis, tumor size >2 cm, moderate differentiation, LVI positivity, and ≥5 {\%} PDC components in the SM1 layer were independent risk factors for LNM in SM1 cancer. Conclusions: The PDC component in the SM layer of differentiated EGC was an independent risk factor of LNM, which might constitute a supplementary criterion in the expanded indications for endoscopic resection in differentiated EGC.",
author = "Jung, {Da Hyun} and Bae, {Yoon Sung} and Yoon, {Sun Och} and Lee, {Yong Chan} and Hoguen Kim and Noh, {Sung Hoon} and Hyojin Park and Choi, {Seung Ho} and Kim, {Jie Hyun} and Hyunki Kim",
year = "2015",
month = "12",
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doi = "10.1245/s10434-015-4794-7",
language = "English",
volume = "22",
pages = "772--777",
journal = "Annals of Surgical Oncology",
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Poorly Differentiated Carcinoma Component in Submucosal Layer Should be Considered as an Additional Criterion for Curative Endoscopic Resection of Early Gastric Cancer. / Jung, Da Hyun; Bae, Yoon Sung; Yoon, Sun Och; Lee, Yong Chan; Kim, Hoguen; Noh, Sung Hoon; Park, Hyojin; Choi, Seung Ho; Kim, Jie Hyun; Kim, Hyunki.

In: Annals of Surgical Oncology, Vol. 22, 01.12.2015, p. 772-777.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Poorly Differentiated Carcinoma Component in Submucosal Layer Should be Considered as an Additional Criterion for Curative Endoscopic Resection of Early Gastric Cancer

AU - Jung, Da Hyun

AU - Bae, Yoon Sung

AU - Yoon, Sun Och

AU - Lee, Yong Chan

AU - Kim, Hoguen

AU - Noh, Sung Hoon

AU - Park, Hyojin

AU - Choi, Seung Ho

AU - Kim, Jie Hyun

AU - Kim, Hyunki

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background: Some studies have reported lymph node metastasis (LNM) in early gastric cancer (EGC) cases meeting the expanded criteria for endoscopic resection. Therefore, we investigated whether a minor poorly differentiated carcinoma (PDC) component in the submucosal (SM) layer affects LNM in differentiated EGC. Methods: We performed surgery in 1096 patients with differentiated SM gastric cancer and compared the clinicopathologic features of node-positive (n = 194) and node-negative (n = 902) differentiated SM cancer, with special reference to the portion of PDC component in the SM layer. Results: When we categorized patients by the proportion of PDC component in the SM layer, we found 840 patients had <5 % and 256 patients had ≥5 % PDC components in the SM layer. The ≥5 % group was significantly associated with younger age, female sex, moderate differentiation, deep SM invasion, lymphovascular invasion (LVI), perineural invasion, and LNM. In multivariate analysis, middle third location, moderate differentiation, SM2 invasion, size >2 cm, LVI, and PDC components in the SM layer were independent risk factors for LNM. When we limited the depth of invasion to SM1, the incidence of LNM was significantly higher in the ≥5 % group. On multivariate analysis, tumor size >2 cm, moderate differentiation, LVI positivity, and ≥5 % PDC components in the SM1 layer were independent risk factors for LNM in SM1 cancer. Conclusions: The PDC component in the SM layer of differentiated EGC was an independent risk factor of LNM, which might constitute a supplementary criterion in the expanded indications for endoscopic resection in differentiated EGC.

AB - Background: Some studies have reported lymph node metastasis (LNM) in early gastric cancer (EGC) cases meeting the expanded criteria for endoscopic resection. Therefore, we investigated whether a minor poorly differentiated carcinoma (PDC) component in the submucosal (SM) layer affects LNM in differentiated EGC. Methods: We performed surgery in 1096 patients with differentiated SM gastric cancer and compared the clinicopathologic features of node-positive (n = 194) and node-negative (n = 902) differentiated SM cancer, with special reference to the portion of PDC component in the SM layer. Results: When we categorized patients by the proportion of PDC component in the SM layer, we found 840 patients had <5 % and 256 patients had ≥5 % PDC components in the SM layer. The ≥5 % group was significantly associated with younger age, female sex, moderate differentiation, deep SM invasion, lymphovascular invasion (LVI), perineural invasion, and LNM. In multivariate analysis, middle third location, moderate differentiation, SM2 invasion, size >2 cm, LVI, and PDC components in the SM layer were independent risk factors for LNM. When we limited the depth of invasion to SM1, the incidence of LNM was significantly higher in the ≥5 % group. On multivariate analysis, tumor size >2 cm, moderate differentiation, LVI positivity, and ≥5 % PDC components in the SM1 layer were independent risk factors for LNM in SM1 cancer. Conclusions: The PDC component in the SM layer of differentiated EGC was an independent risk factor of LNM, which might constitute a supplementary criterion in the expanded indications for endoscopic resection in differentiated EGC.

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JO - Annals of Surgical Oncology

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