Risk factors of lymph node metastasis after non-curative endoscopic resection of undifferentiated-type early gastric cancer View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-07-04

AUTHORS

Hyo-Joon Yang, Jae-Young Jang, Sang Gyun Kim, Ji Yong Ahn, Su Youn Nam, Jie-Hyun Kim, Byung-Hoon Min, Wan-Sik Lee, Bong Eun Lee, Moon Kyung Joo, Jae Myung Park, Woon Geon Shin, Hang Lak Lee, Tae-Geun Gweon, Moo In Park, Jeongmin Choi, Chung Hyun Tae, Young-Il Kim, Il Ju Choi

ABSTRACT

BackgroundThis study aimed to investigate risk factors for lymph node (LN) or distant metastasis after non-curative endoscopic resection (ER) of undifferentiated-type early gastric cancer (EGC).MethodsOf 1124 patients who underwent ER for undifferentiated-type gastric cancer at 18 tertiary hospitals across six geographic areas in Korea between 2005 and 2014, 634 with non-curative ER beyond the expanded criteria were retrospectively enrolled. According to the treatment after ER, patients were divided into additional surgery (n = 270) and follow-up (n = 364) groups. The median follow-up duration was 59 months for recurrence and 84 months for mortality.ResultsLN metastasis was found in 6.7% (18/270) of patients at surgery. Ulcer [odds ratio (OR) 3.83; 95% confidence interval (CI) 1.21–12.13; p = 0.022] and submucosal invasion (OR 10.35; 95% CI 1.35–79.48; p = 0.025) were independent risk factors. In the follow-up group, seven patients (1.9%) developed LN or distant recurrence. Ulcer [hazard ratio (HR) 7.60; 95% CI 1.39–35.74; p = 0.018], LVI (HR 6.80; 95% CI 1.07–42.99; p = 0.042), and positive vertical margin (HR 6.71; 95% CI 1.28–35.19; p = 0.024) were independent risk factors. In the overall cohort, LN metastasis rates were 9.6% in patients with two or more risk factors and 1.2% in those with no or one risk factor.ConclusionsLVI, ulcer, submucosal invasion, and positive vertical margin are independently associated with LN or distant metastasis after non-curative ER of undifferentiated-type EGC. Surgical resection is strongly recommended for patients with two or more risk factors. More... »

PAGES

168-178

Journal

TITLE

Gastric Cancer

ISSUE

1

VOLUME

24

Author Affiliations

  • Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • Department of Internal Medicine, College of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemoon-gu, 02447, Seoul, Korea
  • Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, 110-744, Seoul, Korea
  • Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • Gastroenterology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
  • Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
  • Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
  • Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
  • Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
  • Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
  • Division of Gastroenterology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
  • Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea
  • Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
  • Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
  • Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
  • Center for Gastric Cancer, National Cancer Center, Goyang, Korea
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s10120-020-01103-2

    DOI

    http://dx.doi.org/10.1007/s10120-020-01103-2

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1128993284

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32623585


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