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Risk factors for lymph node metastasis in undifferentiated early gastric cancer.

Authors
 Chen Li  ;  Sungsoo Kim  ;  Ji Fu Lai  ;  Sung Jin Oh  ;  Woo Jin Hyung  ;  Won Hyuk Choi  ;  Seung Ho Choi  ;  Zheng Gang Zhu  ;  Sung Hoon Noh 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.15(3) : 764-769, 2008 
Journal Title
ANNALS OF SURGICAL ONCOLOGY
ISSN
 1068-9265 
Issue Date
2008
MeSH
Female ; Gastrectomy* ; Gastric Mucosa/pathology ; Gastroscopy* ; Humans ; Lymph Node Excision ; Lymphatic Metastasis* ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/therapy
Keywords
Undifferentiated early gastric cancer ; Lymph node metastasis ; Endoscopic surgery
Abstract
BACKGROUND: Endoscopic surgery has not been accepted as a curative treatment for intramucosal undifferentiated early gastric cancer (EGC). The purpose of this study was to evaluate the predictive factors of lymph node metastasis and explore the possibility of using endoscopic surgery for undifferentiated EGC. METHODS: We retrospectively analyzed 646 patients with undifferentiated EGC who had undergone gastrectomy with D2 lymphadenectomy from January 2000 to March 2005. We used univariate and multivariate analysis to identify clinicopathological features that were predictive factors for lymph node metastasis. RESULTS: The incidence of lymph node metastasis was 4.2% in intramucosal and 15.9% in submucosal undifferentiated EGC. Multivariate analysis revealed that submucosal invasion, larger tumor size (greater than 2 cm), and presence of lymphovascular invasion (LVI), were significantly associated with lymph node metastasis in patients with undifferentiated EGC. Tumor size and LVI were independent risk factors for lymph node metastasis in cases of intramucosal EGC. Lymph node metastasis was found in only one patient (0.5%) who had neither of the two risk factors for intramucosal EGC. CONCLUSION: Complete endoscopic resection may be acceptable as a curative treatment for intramucosal undifferentiated EGC when the tumor size is less than or equal to 2 cm, and when LVI is absent in the postoperative histological examination. Radical gastrectomy should be recommended if LVI or unexpected submucosal invasion is present
Full Text
http://link.springer.com/article/10.1245/s10434-007-9707-y
DOI
10.1245/s10434-007-9707-y
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Soo(김성수)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Oh, Sung Jin(오성진)
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Choi, Won Hyuk(최원혁)
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107146
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