The risk of lymph node metastases in 3951 surgically resected mucosal gastric cancers: implications for endoscopic resection

Gastrointestinal Endoscopy
Kang Kook ChoiSung Kim

Abstract

Endoscopic resection for mucosal gastric cancer (MGC) is highly recommended in the absence of lymph node metastasis (LNM). We aimed to clarify the risk factors for LNM in MGC and to investigate the association of LNM with the indication criteria for endoscopic submucosal dissection (ESD). A retrospective cohort study was performed on 3951 patients with MGC who underwent radical gastrectomy at the Samsung Medical Center in Seoul, Republic of Korea, between September 1994 and September 2010. Of the patients with MGC, 101 (2.60%) were positive for LNM. Multivariate analysis, followed by univariate analysis, revealed the following risk factors for LNM in MGC: large tumor size, undifferentiated tumor type, lymphatic invasion, perineural invasion, and associated ulceration in the tumor (hazard ratio 1.25, 7.49, 20.65, 23.45, and 4.07, respectively). Patients without LNM had significantly increased survival and/or recurrence-free survival rates than patients with LNM (188.4/209.8 months vs 169.5/188.0 months; P = .029/.004, respectively). Only 3 of 1065 patients (0.3%) who met the absolute indication criteria for ESD had LNM. Of those who met the expanded indication criteria for ESD, 11 of 2678 patients (0.4%) had LNM. LNM also was fo...Continue Reading

References

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Citations

Oct 22, 2016·Journal of Surgical Oncology·Naruhiko IkomaBrian D Badgwell
Oct 26, 2016·Annals of Surgical Oncology·Naruhiko IkomaBrian D Badgwell
Jul 3, 2018·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Mayank KumarMamta Sinha
Aug 29, 2018·Deutsches Ärzteblatt International·Ines Gockel, Albrecht Hoffmeister
Jun 24, 2021·Asia-Pacific Journal of Clinical Oncology·Chunsheng FangChengwu Zeng
Sep 1, 2021·Surgical Endoscopy·Rosemary NustasField F Willingham

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