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Multifocality in early gastric cancer does not increase the risk of lymph node metastasis in a single-center study

 Hee Man Kim  ;  Hyun Ki Kim  ;  Sang Kil Lee  ;  Jae Hee Cho  ;  Kyung Ho Pak  ;  Woo Jin Hyung  ;  Sung Hoon Noh  ;  Choong Bai Kim  ;  Yong Chan Lee  ;  Si Young Song  ;  Young Hoon Youn 
 ANNALS OF SURGICAL ONCOLOGY, Vol.19(4) : 1251-1256, 2012 
Journal Title
Issue Date
Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/secondary* ; Carcinoma, Signet Ring Cell/mortality ; Carcinoma, Signet Ring Cell/pathology ; Carcinoma, Signet Ring Cell/secondary* ; Female ; Gastrectomy ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology* ; Survival Rate
Endoscopic Submucosal Dissection ; Early Gastric Cancer ; Endoscopic Treatment ; Lymphovascular Invasion ; Signet Ring Cell Carcinoma
BACKGROUND: The multifocality rate of EGC ranges from 4 to 20%, but there are few data regarding both lymph node metastasis and feasibility of the endoscopic treatment. We investigated the risk of lymph node metastasis with the purpose to evaluate the potential for endoscopic treatment in patients with multifocal EGC. METHODS: We retrospectively reviewed the medical records of patients who underwent radical gastrectomy to treat EGC between January 2001 and December 2007 at Severance Hospital, Seoul, Korea. Synchronous multifocal EGC was defined as EGC having two or more malignant foci, whereas solitary EGC was defined as EGC having single focus. RESULTS: Of 1,693 patients, 55 (3.2%) were diagnosed with synchronous multifocal EGC. The rates of lymph node metastasis were 12.7% in synchronous multifocal EGC and 10% in solitary EGC. In the multivariate analysis, synchronous multifocal EGC was not associated with lymph node metastasis (odds ratio, 1.1; 95% confidence interval, 0.4-2.7) compared with solitary EGC. In a subgroup analysis of 55 patients with synchronous multifocal EGC, older age (≥65 years) and lymphovascular invasion were associated with lymph node metastasis. In synchronous multifocal EGC, none of the cases had lymph node metastasis in major and minor lesions representing mucosal cancer without lymphovascular invasion. CONCLUSIONS: Synchronous multifocality of EGC does not increase the risk of lymph node metastasis compared with solitary EGC. Therefore, endoscopic treatment can be planned when major and minor lesions are predicted to represent mucosal cancer without lymphovascular invasion.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Choong Bai(김충배)
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Kim, Hee Man(김희만)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Pak, Kyung Ho(박경호)
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Cho, Jae Hee(조재희)
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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