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    "description": "BackgroundAlthough surgery is recommend for non-curative endoscopic resection of early gastric cancer (EGC), only a part of patients are found to have lymph node (LN) metastasis. This study aimed to identify the predictors of LN metastasis in patients with non-curative endoscopic resection.MethodsBetween April 2005 and July 2013, consecutive patients who received non-curative endoscopic resection and then underwent gastrectomy with lymphadenectomy or followed at least 1\u00a0year with abdominal computed tomography were retrospectively enrolled at a single tertiary hospital. Non-curative resection was defined as a resection beyond the expanded criteria in pathologic mapping. The predictors for LN metastasis were identified by fitting a multivariate logistic regression model.ResultsAmong the 1783 consecutive patients who received endoscopic resection of EGC, non-curative resection was performed in 323 (18.1\u00a0%) patients. Of these patients, a total of 267 patients were enrolled, and the rate of LN metastasis was 6.7\u00a0% (18/267). In multivariate analysis, venous invasion [odds ratio (OR), 7.83; 95\u00a0% confidence interval (CI) 2.20\u201327.86; p\u00a0=\u00a00.001], sm2 invasion (tumor invasion\u00a0\u2265500\u00a0\u00b5m into submucosa; OR 4.98; 95\u00a0% CI 1.34\u201318.47; p\u00a0=\u00a00.016), or antral tumor location (OR 12.65; 95\u00a0% CI 1.57\u2013102.00; p\u00a0=\u00a00.017) were independent predictors for LN metastasis. The rates of LN metastasis were 1.1\u00a0% (95\u00a0% CI 0\u20132.7) for patients with one or no predictor and 17.8\u00a0% (95\u00a0% CI 9.7\u201325.8) for those with two or more predictors.ConclusionsAdditional gastrectomy with lymphadenectomy after non-curative endoscopic resection of EGC is recommended for the patients with two or more identified predictors. However, close follow-up without immediate surgery might be considered cautiously for those with only one or no predictor.", 
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