The risk factors for lymph node metastasis in early gastric cancer patients who underwent endoscopic resection: is the minimal lymph ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-03-19

AUTHORS

Sang Yong Son, Ji Yeon Park, Keun Won Ryu, Bang Wool Eom, Hong Man Yoon, Soo Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Jun Ho Lee, Myeong-Cherl Kook, Il Ju Choi, Young-Woo Kim

ABSTRACT

PurposeThe purpose of this study was to identify risk factors associated with lymph node (LN) metastasis in early gastric cancer patients who underwent endoscopic resection (ER) and to evaluate the feasibility of minimal LN dissection in these patients.MethodsFrom January 2001 to March 2011, patients who underwent gastrectomy with lymphadenectomy due to the potential risk of LN metastasis after ER were enrolled at National Cancer Center, Korea. The incidence, risk factors, and distribution of LN metastasis were evaluated.ResultsOf the 147 enrolled patients, the LN metastasis was identified in 12 patients (8.2 %). The incidence of LN metastasis was not significantly increased in patients with submucosal invasion, lymphovascular invasion, and mixed undifferentiated histology [odds ratio (OR), 5.55, 1.349, and 0.387; 95 % confidence interval (CI), 0.688–43.943, 0.405–4.494, and 0.081–1.84, respectively]. Tumor size more than 2 cm was significantly associated with LN metastasis (OR, 14.056; 95 % CI, 1.76–112.267). The incidence of LN metastasis gradually increased from 3.2 to 20 %, as number of risk factors increased (P = 0.019). LN metastasis was present primarily along the perigastric area in all except two patients (1.4 %) with skip metastasis to extragastric area.ConclusionsStandard surgery with at least D1 + LN dissection must be recommended for patients who proved to have risk factors for LN metastasis after ER, because the potential of skip metastasis is not negligible. Nevertheless, the minimal LN dissection, such as sentinel basin dissection, might be applied cautiously in patients with small-sized tumors after ER. More... »

PAGES

3247-3253

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-013-2901-z

DOI

http://dx.doi.org/10.1007/s00464-013-2901-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1034323150

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23508816


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32 schema:description PurposeThe purpose of this study was to identify risk factors associated with lymph node (LN) metastasis in early gastric cancer patients who underwent endoscopic resection (ER) and to evaluate the feasibility of minimal LN dissection in these patients.MethodsFrom January 2001 to March 2011, patients who underwent gastrectomy with lymphadenectomy due to the potential risk of LN metastasis after ER were enrolled at National Cancer Center, Korea. The incidence, risk factors, and distribution of LN metastasis were evaluated.ResultsOf the 147 enrolled patients, the LN metastasis was identified in 12 patients (8.2 %). The incidence of LN metastasis was not significantly increased in patients with submucosal invasion, lymphovascular invasion, and mixed undifferentiated histology [odds ratio (OR), 5.55, 1.349, and 0.387; 95 % confidence interval (CI), 0.688–43.943, 0.405–4.494, and 0.081–1.84, respectively]. Tumor size more than 2 cm was significantly associated with LN metastasis (OR, 14.056; 95 % CI, 1.76–112.267). The incidence of LN metastasis gradually increased from 3.2 to 20 %, as number of risk factors increased (P = 0.019). LN metastasis was present primarily along the perigastric area in all except two patients (1.4 %) with skip metastasis to extragastric area.ConclusionsStandard surgery with at least D1 + LN dissection must be recommended for patients who proved to have risk factors for LN metastasis after ER, because the potential of skip metastasis is not negligible. Nevertheless, the minimal LN dissection, such as sentinel basin dissection, might be applied cautiously in patients with small-sized tumors after ER.
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39 D1
40 Korea
41 LN dissection
42 LN metastasis
43 National Cancer Center
44 PurposeThe purpose
45 ResultsOf
46 area
47 basin dissection
48 cancer patients
49 center
50 dissection
51 distribution
52 early gastric cancer patients
53 endoscopic resection
54 factors
55 feasibility
56 gastrectomy
57 gastric cancer patients
58 histology
59 incidence
60 invasion
61 lymph node dissection
62 lymph node metastasis
63 lymphadenectomy
64 lymphovascular invasion
65 metastasis
66 node dissection
67 node metastasis
68 number
69 patients
70 perigastric area
71 potential
72 potential risk
73 purpose
74 resection
75 risk
76 risk factors
77 sentinel basin dissection
78 size
79 skip metastasis
80 small-sized tumors
81 study
82 submucosal invasion
83 surgery
84 tumor size
85 tumors
86 undifferentiated histology
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