Risks and benefits of additional surgery for early gastric cancer in the upper third of the stomach meeting non-curative resection criteria after endoscopic submucosal dissection

Autor: Sin Hye Park, Hong Man Yoon, Keun Won Ryu, Young-Woo Kim, Myeong-Cherl Kook, Bang Wool Eom
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: World Journal of Surgical Oncology, Vol 20, Iss 1, Pp 1-8 (2022)
Druh dokumentu: article
ISSN: 1477-7819
DOI: 10.1186/s12957-022-02780-2
Popis: Abstract Background Additional surgery is recommended after non-curative endoscopic submucosal dissection for early gastric cancer. However, it is not easy to recommend for tumors located in the upper third of the stomach, because it would be a total or proximal gastrectomy. This study aimed to evaluate the actual risks and benefits of additional gastrectomy for upper third tumors. Methods We reviewed the clinicopathological data of patients who underwent total or proximal gastrectomy for early gastric cancer in the upper third of the stomach between March 2002 and January 2021. The incidence of lymph node metastasis and postoperative complications were calculated, and risk factors for lymph node metastasis were identified using logistic regression analysis. Survival rates were analyzed using the Kaplan–Meier method and log-rank test. Results A total of 523 patients underwent total or proximal gastrectomy for early gastric cancer; 379 of them had tumors meeting the non-curative resection criteria for endoscopic submucosal dissection. The overall lymph node metastasis rate was 9.5%, and lymphovascular invasion was the only significant risk factor for lymph node metastasis (p
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