Risk factors of lymph node metastasis after non-curative endoscopic resection of undifferentiated-type early gastric cancer
| Autor: | Young-Il Kim, Ji Yong Ahn, Byung-Hoon Min, Jeongmin Choi, Sang Gyun Kim, Il Ju Choi, Jae Myung Park, Tae-Geun Gweon, Jie Hyun Kim, Moo In Park, Woon Geon Shin, Wan Sik Lee, Hyo Joon Yang, Hang Lak Lee, Su Youn Nam, Jae Young Jang, Bong Eun Lee, Chung Hyun Tae, Moon Kyung Joo |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Endoscopic Mucosal Resection Gastroenterology Metastasis 03 medical and health sciences 0302 clinical medicine Gastrectomy Risk Factors Stomach Neoplasms Internal medicine Republic of Korea medicine Odds Ratio Humans Postoperative Period Risk factor Lymph node Aged Retrospective Studies business.industry Hazard ratio Cancer Margins of Excision General Medicine Odds ratio Middle Aged medicine.disease Early Gastric Cancer medicine.anatomical_structure Oncology Gastric Mucosa 030220 oncology & carcinogenesis Lymphatic Metastasis 030211 gastroenterology & hepatology Female Lymph Nodes Neoplasm Recurrence Local business Abdominal surgery |
| Zdroj: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. 24(1) |
| ISSN: | 1436-3305 |
| Popis: | This 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). Of 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. LN 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. LVI, 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. |
| Databáze: | OpenAIRE |
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