Risk factors for lymph node metastasis in early gastric cancer without lymphatic invasion after endoscopic submucosal dissection
Lymphatic invasion (LI) is a potent risk factor for lymph node metastasis (LNM) in early gastric cancer (EGC) after endoscopic submucosal dissection (ESD). However, there are also other risk factors for LNM. Hence, to identify the need for additional surgery in some case of EGC without LI, the prese...
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| Veröffentlicht in: | European journal of surgical oncology 2021-12, Vol.47 (12), p.3059-3063 |
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| creator | Oh, Yoon Jung Kim, Deok Hee Han, Won Ho Eom, Bang Wool Kim, Young Il Yoon, Hong Man Lee, Jong Yeul Kim, Chan Gyoo Kook, Myeong-Cherl Choi, Il Ju Kim, Young-Woo Ryu, Keun Won |
| description | Lymphatic invasion (LI) is a potent risk factor for lymph node metastasis (LNM) in early gastric cancer (EGC) after endoscopic submucosal dissection (ESD). However, there are also other risk factors for LNM. Hence, to identify the need for additional surgery in some case of EGC without LI, the present study aimed to identify the risk factors for LNM in patients with EGC without LI.
Data from 2284 patients diagnosed with EGC who underwent curative surgery at National Cancer Center in Korea from January 2012 to May 2019 were collected. The clinicopathological characteristics of patients with EGC without LI were compared on the basis of LNM status.
There were 339 (17.1%) and 1648 (82.9%) patients with and without LI respectively. Among these patients with and without LI, 118 (34.8%) and 91 (5.5%) patients presented with LNM, respectively. In patients with EGC without LI, tumor size larger than 3 cm (OR = 2.12, 95% CI = 1.22–3.68; p = 0.007), submucosal invasion (OR = 4.14, 95% CI = 2.57–6.65; p |
| doi_str_mv | 10.1016/j.ejso.2021.04.029 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2521498660</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0748798321004571</els_id><sourcerecordid>2521498660</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-59b03a61e47ca3bf04f3b0935abfc04fab23c28ec93b3e6d6425175246d1d9173</originalsourceid><addsrcrecordid>eNp9kM1q3DAURkVJaSZpXyCLomU2dvVnewTZhJC0gUChJGshS9eNJrY11ZVTZpdHr4ZJsiwIhHTP98E9hJxxVnPG22-bGjYYa8EEr5mqmdAfyIo3UlSCN90RWbFOratOr-UxOUHcMMa07PQnciyllkpLvSIvvwI-0cG6HBPSISY67qbtI52jBzpBtlhOQBpmCjaNO_q7_KTgqLOzg0T_hvwYl3xI2VwGYX4uiThTO-QCwOwjurgtE1z6aXER7Uh9QASXC_aZfBzsiPDl9T4lDzfX91c_qruf32-vLu8qp1iTq0b3TNqWg-qclf3A1CD7sk5j-8GVh-2FdGINTsteQutbJRreNUK1nnvNO3lKzg-92xT_LIDZTAEdjKOdIS5oRCO40uu2ZQUVB9SliJhgMNsUJpt2hjOzN282Zm_e7M0bpkwxX0JfX_vLluDfI2-qC3BxAKBs-RwgGXQBikQfUlFhfAz_6_8HcJKYJw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2521498660</pqid></control><display><type>article</type><title>Risk factors for lymph node metastasis in early gastric cancer without lymphatic invasion after endoscopic submucosal dissection</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Oh, Yoon Jung ; Kim, Deok Hee ; Han, Won Ho ; Eom, Bang Wool ; Kim, Young Il ; Yoon, Hong Man ; Lee, Jong Yeul ; Kim, Chan Gyoo ; Kook, Myeong-Cherl ; Choi, Il Ju ; Kim, Young-Woo ; Ryu, Keun Won</creator><creatorcontrib>Oh, Yoon Jung ; Kim, Deok Hee ; Han, Won Ho ; Eom, Bang Wool ; Kim, Young Il ; Yoon, Hong Man ; Lee, Jong Yeul ; Kim, Chan Gyoo ; Kook, Myeong-Cherl ; Choi, Il Ju ; Kim, Young-Woo ; Ryu, Keun Won</creatorcontrib><description>Lymphatic invasion (LI) is a potent risk factor for lymph node metastasis (LNM) in early gastric cancer (EGC) after endoscopic submucosal dissection (ESD). However, there are also other risk factors for LNM. Hence, to identify the need for additional surgery in some case of EGC without LI, the present study aimed to identify the risk factors for LNM in patients with EGC without LI.
Data from 2284 patients diagnosed with EGC who underwent curative surgery at National Cancer Center in Korea from January 2012 to May 2019 were collected. The clinicopathological characteristics of patients with EGC without LI were compared on the basis of LNM status.
There were 339 (17.1%) and 1648 (82.9%) patients with and without LI respectively. Among these patients with and without LI, 118 (34.8%) and 91 (5.5%) patients presented with LNM, respectively. In patients with EGC without LI, tumor size larger than 3 cm (OR = 2.12, 95% CI = 1.22–3.68; p = 0.007), submucosal invasion (OR = 4.14, 95% CI = 2.57–6.65; p < 0.001), and undifferentiated histologic type (OR = 2.33, 95% CI = 1.45–3.76; p < 0.001) were significant risk factors for LNM. Rates of LNM in patients meeting absolute, expanded, and beyond expanded criteria without LI were 0%, 1.5% (OR = 3.27, 95% CI = 0.18–59.41; p = 0.423), and 7.3% respectively. When the expanded criteria were divided into four subtypes patients with EGC, without LI within each subtype did not show significant risk of incidence of LNM compared to the absolute criteria.
The current expanded criteria for endoscopic resection (ER) are tolerable in cases without LI, even though minimal risk LNM exists. Therefore, additional surgery may not be needed for patients meeting expanded criteria for ER.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2021.04.029</identifier><identifier>PMID: 33934939</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Early gastric cancer ; Endoscopic Mucosal Resection ; Endoscopic submucosal dissection ; Female ; Humans ; Lymph node metastasis ; Lymphatic invasion ; Lymphatic Metastasis - pathology ; Male ; Middle Aged ; Reoperation ; Republic of Korea ; Risk Factors ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery</subject><ispartof>European journal of surgical oncology, 2021-12, Vol.47 (12), p.3059-3063</ispartof><rights>2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology</rights><rights>Copyright © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-59b03a61e47ca3bf04f3b0935abfc04fab23c28ec93b3e6d6425175246d1d9173</citedby><cites>FETCH-LOGICAL-c405t-59b03a61e47ca3bf04f3b0935abfc04fab23c28ec93b3e6d6425175246d1d9173</cites><orcidid>0000-0003-3728-2788</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0748798321004571$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33934939$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oh, Yoon Jung</creatorcontrib><creatorcontrib>Kim, Deok Hee</creatorcontrib><creatorcontrib>Han, Won Ho</creatorcontrib><creatorcontrib>Eom, Bang Wool</creatorcontrib><creatorcontrib>Kim, Young Il</creatorcontrib><creatorcontrib>Yoon, Hong Man</creatorcontrib><creatorcontrib>Lee, Jong Yeul</creatorcontrib><creatorcontrib>Kim, Chan Gyoo</creatorcontrib><creatorcontrib>Kook, Myeong-Cherl</creatorcontrib><creatorcontrib>Choi, Il Ju</creatorcontrib><creatorcontrib>Kim, Young-Woo</creatorcontrib><creatorcontrib>Ryu, Keun Won</creatorcontrib><title>Risk factors for lymph node metastasis in early gastric cancer without lymphatic invasion after endoscopic submucosal dissection</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>Lymphatic invasion (LI) is a potent risk factor for lymph node metastasis (LNM) in early gastric cancer (EGC) after endoscopic submucosal dissection (ESD). However, there are also other risk factors for LNM. Hence, to identify the need for additional surgery in some case of EGC without LI, the present study aimed to identify the risk factors for LNM in patients with EGC without LI.
Data from 2284 patients diagnosed with EGC who underwent curative surgery at National Cancer Center in Korea from January 2012 to May 2019 were collected. The clinicopathological characteristics of patients with EGC without LI were compared on the basis of LNM status.
There were 339 (17.1%) and 1648 (82.9%) patients with and without LI respectively. Among these patients with and without LI, 118 (34.8%) and 91 (5.5%) patients presented with LNM, respectively. In patients with EGC without LI, tumor size larger than 3 cm (OR = 2.12, 95% CI = 1.22–3.68; p = 0.007), submucosal invasion (OR = 4.14, 95% CI = 2.57–6.65; p < 0.001), and undifferentiated histologic type (OR = 2.33, 95% CI = 1.45–3.76; p < 0.001) were significant risk factors for LNM. Rates of LNM in patients meeting absolute, expanded, and beyond expanded criteria without LI were 0%, 1.5% (OR = 3.27, 95% CI = 0.18–59.41; p = 0.423), and 7.3% respectively. When the expanded criteria were divided into four subtypes patients with EGC, without LI within each subtype did not show significant risk of incidence of LNM compared to the absolute criteria.
The current expanded criteria for endoscopic resection (ER) are tolerable in cases without LI, even though minimal risk LNM exists. Therefore, additional surgery may not be needed for patients meeting expanded criteria for ER.</description><subject>Early gastric cancer</subject><subject>Endoscopic Mucosal Resection</subject><subject>Endoscopic submucosal dissection</subject><subject>Female</subject><subject>Humans</subject><subject>Lymph node metastasis</subject><subject>Lymphatic invasion</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Reoperation</subject><subject>Republic of Korea</subject><subject>Risk Factors</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1q3DAURkVJaSZpXyCLomU2dvVnewTZhJC0gUChJGshS9eNJrY11ZVTZpdHr4ZJsiwIhHTP98E9hJxxVnPG22-bGjYYa8EEr5mqmdAfyIo3UlSCN90RWbFOratOr-UxOUHcMMa07PQnciyllkpLvSIvvwI-0cG6HBPSISY67qbtI52jBzpBtlhOQBpmCjaNO_q7_KTgqLOzg0T_hvwYl3xI2VwGYX4uiThTO-QCwOwjurgtE1z6aXER7Uh9QASXC_aZfBzsiPDl9T4lDzfX91c_qruf32-vLu8qp1iTq0b3TNqWg-qclf3A1CD7sk5j-8GVh-2FdGINTsteQutbJRreNUK1nnvNO3lKzg-92xT_LIDZTAEdjKOdIS5oRCO40uu2ZQUVB9SliJhgMNsUJpt2hjOzN282Zm_e7M0bpkwxX0JfX_vLluDfI2-qC3BxAKBs-RwgGXQBikQfUlFhfAz_6_8HcJKYJw</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Oh, Yoon Jung</creator><creator>Kim, Deok Hee</creator><creator>Han, Won Ho</creator><creator>Eom, Bang Wool</creator><creator>Kim, Young Il</creator><creator>Yoon, Hong Man</creator><creator>Lee, Jong Yeul</creator><creator>Kim, Chan Gyoo</creator><creator>Kook, Myeong-Cherl</creator><creator>Choi, Il Ju</creator><creator>Kim, Young-Woo</creator><creator>Ryu, Keun Won</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3728-2788</orcidid></search><sort><creationdate>202112</creationdate><title>Risk factors for lymph node metastasis in early gastric cancer without lymphatic invasion after endoscopic submucosal dissection</title><author>Oh, Yoon Jung ; Kim, Deok Hee ; Han, Won Ho ; Eom, Bang Wool ; Kim, Young Il ; Yoon, Hong Man ; Lee, Jong Yeul ; Kim, Chan Gyoo ; Kook, Myeong-Cherl ; Choi, Il Ju ; Kim, Young-Woo ; Ryu, Keun Won</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-59b03a61e47ca3bf04f3b0935abfc04fab23c28ec93b3e6d6425175246d1d9173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Early gastric cancer</topic><topic>Endoscopic Mucosal Resection</topic><topic>Endoscopic submucosal dissection</topic><topic>Female</topic><topic>Humans</topic><topic>Lymph node metastasis</topic><topic>Lymphatic invasion</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Reoperation</topic><topic>Republic of Korea</topic><topic>Risk Factors</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oh, Yoon Jung</creatorcontrib><creatorcontrib>Kim, Deok Hee</creatorcontrib><creatorcontrib>Han, Won Ho</creatorcontrib><creatorcontrib>Eom, Bang Wool</creatorcontrib><creatorcontrib>Kim, Young Il</creatorcontrib><creatorcontrib>Yoon, Hong Man</creatorcontrib><creatorcontrib>Lee, Jong Yeul</creatorcontrib><creatorcontrib>Kim, Chan Gyoo</creatorcontrib><creatorcontrib>Kook, Myeong-Cherl</creatorcontrib><creatorcontrib>Choi, Il Ju</creatorcontrib><creatorcontrib>Kim, Young-Woo</creatorcontrib><creatorcontrib>Ryu, Keun Won</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oh, Yoon Jung</au><au>Kim, Deok Hee</au><au>Han, Won Ho</au><au>Eom, Bang Wool</au><au>Kim, Young Il</au><au>Yoon, Hong Man</au><au>Lee, Jong Yeul</au><au>Kim, Chan Gyoo</au><au>Kook, Myeong-Cherl</au><au>Choi, Il Ju</au><au>Kim, Young-Woo</au><au>Ryu, Keun Won</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for lymph node metastasis in early gastric cancer without lymphatic invasion after endoscopic submucosal dissection</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2021-12</date><risdate>2021</risdate><volume>47</volume><issue>12</issue><spage>3059</spage><epage>3063</epage><pages>3059-3063</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><abstract>Lymphatic invasion (LI) is a potent risk factor for lymph node metastasis (LNM) in early gastric cancer (EGC) after endoscopic submucosal dissection (ESD). However, there are also other risk factors for LNM. Hence, to identify the need for additional surgery in some case of EGC without LI, the present study aimed to identify the risk factors for LNM in patients with EGC without LI.
Data from 2284 patients diagnosed with EGC who underwent curative surgery at National Cancer Center in Korea from January 2012 to May 2019 were collected. The clinicopathological characteristics of patients with EGC without LI were compared on the basis of LNM status.
There were 339 (17.1%) and 1648 (82.9%) patients with and without LI respectively. Among these patients with and without LI, 118 (34.8%) and 91 (5.5%) patients presented with LNM, respectively. In patients with EGC without LI, tumor size larger than 3 cm (OR = 2.12, 95% CI = 1.22–3.68; p = 0.007), submucosal invasion (OR = 4.14, 95% CI = 2.57–6.65; p < 0.001), and undifferentiated histologic type (OR = 2.33, 95% CI = 1.45–3.76; p < 0.001) were significant risk factors for LNM. Rates of LNM in patients meeting absolute, expanded, and beyond expanded criteria without LI were 0%, 1.5% (OR = 3.27, 95% CI = 0.18–59.41; p = 0.423), and 7.3% respectively. When the expanded criteria were divided into four subtypes patients with EGC, without LI within each subtype did not show significant risk of incidence of LNM compared to the absolute criteria.
The current expanded criteria for endoscopic resection (ER) are tolerable in cases without LI, even though minimal risk LNM exists. Therefore, additional surgery may not be needed for patients meeting expanded criteria for ER.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33934939</pmid><doi>10.1016/j.ejso.2021.04.029</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-3728-2788</orcidid></addata></record> |
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| subjects | Early gastric cancer Endoscopic Mucosal Resection Endoscopic submucosal dissection Female Humans Lymph node metastasis Lymphatic invasion Lymphatic Metastasis - pathology Male Middle Aged Reoperation Republic of Korea Risk Factors Stomach Neoplasms - pathology Stomach Neoplasms - surgery |
| title | Risk factors for lymph node metastasis in early gastric cancer without lymphatic invasion after endoscopic submucosal dissection |
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