Risk factors for lymph node metastasis in undifferentiated early gastric cancer

Chen Li, Sungsoo Kim, Ji Fu Lai, Sung Jin Oh, WooJin Hyung, Won Hyuk Choi, Seung Ho Choi, Zheng Gang Zhu, Sung Hoon Noh

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Abstract

Background: Endoscopic surgery has not been accepted as a curative treatment for intramucosal undifferentiated early gastric cancer (EGC). The purpose of this study was to evaluate the predictive factors of lymph node metastasis and explore the possibility of using endoscopic surgery for undifferentiated EGC. Methods: We retrospectively analyzed 646 patients with undifferentiated EGC who had undergone gastrectomy with D2 lymphadenectomy from January 2000 to March 2005. We used univariate and multivariate analysis to identify clinicopathological features that were predictive factors for lymph node metastasis. Results: The incidence of lymph node metastasis was 4.2% in intramucosal and 15.9% in submucosal undifferentiated EGC. Multivariate analysis revealed that submucosal invasion, larger tumor size (greater than 2 cm), and presence of lymphovascular invasion (LVI), were significantly associated with lymph node metastasis in patients with undifferentiated EGC. Tumor size and LVI were independent risk factors for lymph node metastasis in cases of intramucosal EGC. Lymph node metastasis was found in only one patient (0.5%) who had neither of the two risk factors for intramucosal EGC. Conclusion: Complete endoscopic resection may be acceptable as a curative treatment for intramucosal undifferentiated EGC when the tumor size is less than or equal to 2 cm, and when LVI is absent in the postoperative histological examination. Radical gastrectomy should be recommended if LVI or unexpected submucosal invasion is present.

Original languageEnglish
Pages (from-to)764-769
Number of pages6
JournalAnnals of Surgical Oncology
Volume15
Issue number3
DOIs
Publication statusPublished - 2008 Mar 1

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Stomach Neoplasms
Lymph Nodes
Neoplasm Metastasis
Gastrectomy
Multivariate Analysis
Neoplasms
Lymph Node Excision
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Li, Chen ; Kim, Sungsoo ; Lai, Ji Fu ; Oh, Sung Jin ; Hyung, WooJin ; Choi, Won Hyuk ; Choi, Seung Ho ; Zhu, Zheng Gang ; Noh, Sung Hoon. / Risk factors for lymph node metastasis in undifferentiated early gastric cancer. In: Annals of Surgical Oncology. 2008 ; Vol. 15, No. 3. pp. 764-769.
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abstract = "Background: Endoscopic surgery has not been accepted as a curative treatment for intramucosal undifferentiated early gastric cancer (EGC). The purpose of this study was to evaluate the predictive factors of lymph node metastasis and explore the possibility of using endoscopic surgery for undifferentiated EGC. Methods: We retrospectively analyzed 646 patients with undifferentiated EGC who had undergone gastrectomy with D2 lymphadenectomy from January 2000 to March 2005. We used univariate and multivariate analysis to identify clinicopathological features that were predictive factors for lymph node metastasis. Results: The incidence of lymph node metastasis was 4.2{\%} in intramucosal and 15.9{\%} in submucosal undifferentiated EGC. Multivariate analysis revealed that submucosal invasion, larger tumor size (greater than 2 cm), and presence of lymphovascular invasion (LVI), were significantly associated with lymph node metastasis in patients with undifferentiated EGC. Tumor size and LVI were independent risk factors for lymph node metastasis in cases of intramucosal EGC. Lymph node metastasis was found in only one patient (0.5{\%}) who had neither of the two risk factors for intramucosal EGC. Conclusion: Complete endoscopic resection may be acceptable as a curative treatment for intramucosal undifferentiated EGC when the tumor size is less than or equal to 2 cm, and when LVI is absent in the postoperative histological examination. Radical gastrectomy should be recommended if LVI or unexpected submucosal invasion is present.",
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Li, C, Kim, S, Lai, JF, Oh, SJ, Hyung, W, Choi, WH, Choi, SH, Zhu, ZG & Noh, SH 2008, 'Risk factors for lymph node metastasis in undifferentiated early gastric cancer', Annals of Surgical Oncology, vol. 15, no. 3, pp. 764-769. https://doi.org/10.1245/s10434-007-9707-y

Risk factors for lymph node metastasis in undifferentiated early gastric cancer. / Li, Chen; Kim, Sungsoo; Lai, Ji Fu; Oh, Sung Jin; Hyung, WooJin; Choi, Won Hyuk; Choi, Seung Ho; Zhu, Zheng Gang; Noh, Sung Hoon.

In: Annals of Surgical Oncology, Vol. 15, No. 3, 01.03.2008, p. 764-769.

Research output: Contribution to journalArticle

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T1 - Risk factors for lymph node metastasis in undifferentiated early gastric cancer

AU - Li, Chen

AU - Kim, Sungsoo

AU - Lai, Ji Fu

AU - Oh, Sung Jin

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AU - Choi, Won Hyuk

AU - Choi, Seung Ho

AU - Zhu, Zheng Gang

AU - Noh, Sung Hoon

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N2 - Background: Endoscopic surgery has not been accepted as a curative treatment for intramucosal undifferentiated early gastric cancer (EGC). The purpose of this study was to evaluate the predictive factors of lymph node metastasis and explore the possibility of using endoscopic surgery for undifferentiated EGC. Methods: We retrospectively analyzed 646 patients with undifferentiated EGC who had undergone gastrectomy with D2 lymphadenectomy from January 2000 to March 2005. We used univariate and multivariate analysis to identify clinicopathological features that were predictive factors for lymph node metastasis. Results: The incidence of lymph node metastasis was 4.2% in intramucosal and 15.9% in submucosal undifferentiated EGC. Multivariate analysis revealed that submucosal invasion, larger tumor size (greater than 2 cm), and presence of lymphovascular invasion (LVI), were significantly associated with lymph node metastasis in patients with undifferentiated EGC. Tumor size and LVI were independent risk factors for lymph node metastasis in cases of intramucosal EGC. Lymph node metastasis was found in only one patient (0.5%) who had neither of the two risk factors for intramucosal EGC. Conclusion: Complete endoscopic resection may be acceptable as a curative treatment for intramucosal undifferentiated EGC when the tumor size is less than or equal to 2 cm, and when LVI is absent in the postoperative histological examination. Radical gastrectomy should be recommended if LVI or unexpected submucosal invasion is present.

AB - Background: Endoscopic surgery has not been accepted as a curative treatment for intramucosal undifferentiated early gastric cancer (EGC). The purpose of this study was to evaluate the predictive factors of lymph node metastasis and explore the possibility of using endoscopic surgery for undifferentiated EGC. Methods: We retrospectively analyzed 646 patients with undifferentiated EGC who had undergone gastrectomy with D2 lymphadenectomy from January 2000 to March 2005. We used univariate and multivariate analysis to identify clinicopathological features that were predictive factors for lymph node metastasis. Results: The incidence of lymph node metastasis was 4.2% in intramucosal and 15.9% in submucosal undifferentiated EGC. Multivariate analysis revealed that submucosal invasion, larger tumor size (greater than 2 cm), and presence of lymphovascular invasion (LVI), were significantly associated with lymph node metastasis in patients with undifferentiated EGC. Tumor size and LVI were independent risk factors for lymph node metastasis in cases of intramucosal EGC. Lymph node metastasis was found in only one patient (0.5%) who had neither of the two risk factors for intramucosal EGC. Conclusion: Complete endoscopic resection may be acceptable as a curative treatment for intramucosal undifferentiated EGC when the tumor size is less than or equal to 2 cm, and when LVI is absent in the postoperative histological examination. Radical gastrectomy should be recommended if LVI or unexpected submucosal invasion is present.

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