Incidence of lymph node metastasis in intramucosal gastric cancer measuring 30 mm or less, with ulceration; mixed, predominantly differentiated-type histology; and no lymphovascular invasion: a multicenter retrospective study

Autor: Tadakazu Shimoda, Kei Kawagoe, Tomonori Yano, Toshiro Iizuka, Eiji Umegaki, Shinichiro Hori, Manabu Muto, Yorimasa Yamamoto, Mitsuru Sasako, Kohei Takizawa, Hitoshi Katai, Shunya Sasaki, Hiroyuki Ono
Rok vydání: 2015
Předmět:
Male
Cancer Research
Lymphovascular invasion
medicine.medical_treatment
Gastroenterology
0302 clinical medicine
Japan
Surgical oncology
Lymph node
Aged
80 and over
Incidence
Cell Differentiation
General Medicine
Middle Aged
Prognosis
Adenocarcinoma
Mucinous
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Lymphatic Metastasis
030211 gastroenterology & hepatology
Female
Adult
medicine.medical_specialty
Adenocarcinoma
03 medical and health sciences
Young Adult
Gastrectomy
Stomach Neoplasms
Internal medicine
Gastroscopy
medicine
Humans
Neoplasm Invasiveness
Stomach Ulcer
Aged
Neoplasm Staging
Retrospective Studies
business.industry
Cancer
Retrospective cohort study
medicine.disease
Surgery
Early Gastric Cancer
Gastric Mucosa
Lymph Nodes
business
Carcinoma
Signet Ring Cell
Abdominal surgery
Follow-Up Studies
Zdroj: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. 19(4)
ISSN: 1436-3305
Popis: Intramucosal gastric cancer, ≤3 cm (≤30 mm) with ulceration, and mixed histology (predominantly differentiated), was previously considered curative after endoscopic resection, and additional surgery was thought to be unnecessary. However, as the evidence base for these criteria remains insufficient, the Japanese Gastric Cancer Treatment Guidelines, ver. 3 (2010) specify that this pathology should be considered noncurative and recommend additional surgery. We report the frequency of lymph node metastasis in patients with these conditions based on a multicenter study. Of patients with early gastric cancer who underwent gastrectomy with lymph node dissection, those with a mixed, predominantly differentiated tumor type, ulceration, a tumor diameter ≤3 cm, and no lymphovascular invasion were entered into this study. Four hundred and seven patients met the criteria, 21 of whom were excluded owing to a lack of available information. Thus, a total of 386 patients were included in the analysis, from 37 of the 42 member institutions. The mean study duration was 125 months. The most common combination of mixed histology was tub2 + por (67 %). None of the 386 patients had lymph node metastasis (95 % confidence interval, 0–0.8 %). The results of this retrospective study indicate that the risk of lymph node metastasis was less than 1 % among patients with the criteria defined here, considered to be criteria for noncurative resection as per the current guidelines, and suggest that observation alone without additional surgery may result in a good outcome.
Databáze: OpenAIRE
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