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Predictive factors for lymph node metastasis and endoscopic treatment strategies for undifferentiated early gastric cancer

Cited 57 time in Web of Science Cited 59 time in Scopus
Authors
Ye, Byong D; Kim, Sang G; Lee, Jong Y; Kim, Joo S; Yang, Han-Kwang; Kim, Woo H; Jung, Hyun C; Lee, Kuhn U; Song, In S
Issue Date
2008-01-04
Publisher
Wiley-Blackwell
Citation
J Gastroenterol Hepatol. 2008 Jan;23(1):46-50.
Keywords
Adenocarcinoma/*pathology/*surgeryAgedFemale*GastroscopyHumansLymphatic MetastasisMaleMiddle AgedRetrospective StudiesRisk FactorsStomach Neoplasms/*pathology/*surgery
Abstract
BACKGROUND AND AIM: Although more than 80% of undifferentiated early gastric cancers (EGC) are not associated with lymph node metastasis, endoscopic mucosal resection is not generally accepted as a means of curative treatment because of an abundance of conflicting data concerning clinicopathological characteristics and prognoses. The aim of this study was to define a subgroup of undifferentiated EGC that could be cured by endoscopic treatment without the risk of lymph node metastasis. METHOD: A total of 591 patients surgically resected for undifferentiated EGC between January 1999 and March 2005 were reviewed. Associations between various clinicopathological factors and the presence of lymph node metastasis were analyzed to identify the risk factors of lymph node metastasis. RESULTS: Lymph node metastasis was found in 79 patients (13.4%). By multivariate logistic regression analysis, a tumor diameter 2.5 cm or larger, invasion into the middle third of the submucosal layer or deeper, and lymphatic involvement were identified as independent risk factors of lymph node metastasis (P < 0.001, respectively). Lymph node metastasis was not found in any patient with undifferentiated EGC smaller than 2.5 cm confined to the mucosa or upper third of the submucosal layer without lymphatic involvement. CONCLUSIONS: Undifferentiated intramucosal EGC smaller than 2.5 cm without lymphatic involvement was not associated with lymph node metastasis. Thus, we propose in this circumstance that endoscopic mucosal resection could be considered a definitive treatment without compromising the possibility of cure.
ISSN
1440-1746 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18171341

http://hdl.handle.net/10371/29565
DOI
https://doi.org/10.1111/j.1440-1746.2006.04791.x
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College of Medicine/School of Medicine (의과대학/대학원)Program in Cancer Biology (협동과정-종양생물학전공)Journal Papers (저널논문_협동과정-종양생물학전공)
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