Predicting the absence of lymph node metastasis of submucosal invasive gastric cancer: expansion of the criteria for curative endoscopic resection

Scandinavian Journal of Gastroenterology
Yoji SanomuraKazuaki Chayama

Abstract

The conditions upon which endoscopic resection (ER) can be considered curative for submucosal invasive gastric cancer remain controversial; thus, unnecessary surgery is sometimes performed after ER. Our purpose is to evaluate the significance of several clinicopathological factors for predicting the absence of lymph node (LN) metastasis of submucosal invasive gastric cancer and thus determining cases in which ER can be considered curative. The study group comprised 220 patients with submucosal invasive gastric cancer that was resected surgically or endoscopically. Patients treated by ER underwent additional surgical resection. The presence of LN metastasis was evaluated in all patients, retrospectively. LN metastasis was detected in 37 (16.8%) of the 220 patients. Independent risk factors for LN metastasis were width of submucosal invasion>6000 μm, lymphatic involvement, undifferentiated type at the deepest invasive portion, depth of submucosal invasion>1000 μm, and tumor diameter>30 mm. The group of 36 patients with submucosal invasion to a depth of ≤1000 μm, tumor diameter ≤30 mm, differentiated type as the dominant histologic type, and absence of vessel involvement was entirely free of LN metastasis (95% confidence interval,...Continue Reading

References

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Citations

Jul 26, 2011·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Yoji SanomuraKazuaki Chayama
Oct 12, 2012·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Makoto HigashimayaKazuaki Chayama
Mar 29, 2014·Gastroenterology Research and Practice·Tomoyuki BodaKazuaki Chayama
Oct 22, 2013·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Yoji SanomuraKazuaki Chayama
Dec 5, 2012·Gastrointestinal Endoscopy·Makoto HigashimayaKazuaki Chayama
Apr 9, 2013·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Takashi KosakaTamotsu Sugai
Oct 18, 2016·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Toshiyasu OjimaHiroki Yamaue
Jun 24, 2020·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Kazutaka KurokiKazuaki Chayama

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