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Predictive factors for lymph node metastasis and defining a subgroup treatable for laparoscopic lymph node dissection after endoscopic submucosal dissection in poorly differentiated early gastric cancer 被引量:3

Predictive factors for lymph node metastasis and defining a subgroup treatable for laparoscopic lymph node dissection after endoscopic submucosal dissection in poorly differentiated early gastric cancer
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摘要 AIM To investigate the predictive factors of lymph node metastasis(LNM)in poorly differentiated early gastric cancer(EGC);to guide the individual application of a combination of endoscopic submucosal dissection(ESD)and laparoscopic lymph node dissection(LLND)in a suitable subgroup of patients with poorly differentiated EGC.METHODS We retrospectively analyzed 138 patients with poorly differentiated EGC who underwent gastrectomy with lymphadenectomy between January 1990 and December 2015.The association between the clinicopathological factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses.Odds ratios(OR)with 95%confidence interval(95%CI)were calculated.We further examined the relationship between the positive number of the significant predictive factors and the LNM rate.RESULTS The tumor diameter(OR=13.438,95%CI:1.773-25.673,P=0.029),lymphatic vessel involvement(LVI)(OR=38.521,95%CI:1.975-68.212,P=0.015)and depth of invasion(OR=14.981,95%CI:1.617-52.844,P=0.024)were found to be independent risk factors for LNM by multivariate analysis.For the 138 patients diagnosed with poorly differentiated EGC,21(15.2%)had LNM.For patients with one,two and three of the risk factors,the LNM rates were 7.7%,47.6%and 64.3%,respectively.LNM was not found in 77 patients that did not have one or more of the three risk factors.CONCLUSION ESD might be sufficient treatment for intramucosal poorly differentiated EGC if the tumor is less than or equal to2 cm in size and when LVI is absent upon postoperative histological examination.ESD with LLND may lead to the elimination of unnecessary gastrectomy in poorly differentiated EGC. AIM To investigate the predictive factors of lymph node metastasis(LNM)in poorly differentiated early gastric cancer(EGC);to guide the individual application of a combination of endoscopic submucosal dissection(ESD)and laparoscopic lymph node dissection(LLND)in a suitable subgroup of patients with poorly differentiated EGC.METHODS We retrospectively analyzed 138 patients with poorly differentiated EGC who underwent gastrectomy with lymphadenectomy between January 1990 and December 2015.The association between the clinicopathological factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses.Odds ratios(OR)with 95%confidence interval(95%CI)were calculated.We further examined the relationship between the positive number of the significant predictive factors and the LNM rate.RESULTS The tumor diameter(OR=13.438,95%CI:1.773-25.673,P=0.029),lymphatic vessel involvement(LVI)(OR=38.521,95%CI:1.975-68.212,P=0.015)and depth of invasion(OR=14.981,95%CI:1.617-52.844,P=0.024)were found to be independent risk factors for LNM by multivariate analysis.For the 138 patients diagnosed with poorly differentiated EGC,21(15.2%)had LNM.For patients with one,two and three of the risk factors,the LNM rates were 7.7%,47.6%and 64.3%,respectively.LNM was not found in 77 patients that did not have one or more of the three risk factors.CONCLUSION ESD might be sufficient treatment for intramucosal poorly differentiated EGC if the tumor is less than or equal to2 cm in size and when LVI is absent upon postoperative histological examination.ESD with LLND may lead to the elimination of unnecessary gastrectomy in poorly differentiated EGC.
出处 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2018年第10期360-366,共7页 世界胃肠肿瘤学杂志(英文版)(电子版)
关键词 Poorly differentiated CANCER LAPAROSCOPIC LYMPH NODE DISSECTION LYMPH NODE metastasis Early gastric CANCER Endoscopic SUBMUCOSAL DISSECTION Poorly differentiated cancer Laparoscopic lymph node dissection Lymph node metastasis Early gastric cancer Endoscopic submucosal dissection
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  • 1Japanese Classification of Gastric Carcinoma – 2nd English Edition –[J]. Gastric Cancer . 1998 (1)
  • 2H. Yamamoto,H. Kawata,K. Sunada,A. Sasaki,K. Nakazawa,T. Miyata,Y. Sekine,T. Yano,K. Satoh,K. Ido,K. Sugano.Successful En-Bloc Resection of Large Superficial Tumors in the Stomach and Colon Using Sodium Hyaluronate and Small-Caliber-Tip Transparent Hood[J].Endoscopy.2003(08)
  • 3Yi Young Kim,Seong Woo Jeon,JiYeon Kim,Jung Chul Park,Kwang Bum Cho,Kyung Sik Park,EunSoo Kim,Yun Jin Chung,Joong Goo Kwon,Jin Tae Jung,Eun Young Kim,Kyeong Ok Kim,ByungIk Jang,Si Hyung Lee,Chang Hun Yang.Endoscopic submucosal dissection for early gastric cancer with undifferentiated histology: could we extend the criteria beyond?[J].Surgical Endoscopy.2013(12)
  • 4Shiro Oka,Shinji Tanaka,Iwao Kaneko,Ritsuo Mouri,Mayuko Hirata,Toru Kawamura,Masaharu Yoshihara,Kazuaki Chayama.Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer[J].Gastrointestinal Endoscopy.2006(6)
  • 5Yuko Kitagawa,Seigo Kitano,Tetsuro Kubota,Koichiro Kumai,Yoshihide Otani,Yoshiro Saikawa,Masashi Yoshida,Masaki Kitajima.Minimally invasive surgery for gastric cancer — toward a confluence of two major streams: a review[J].Gastric Cancer.2005(2)
  • 6Ichiro Oda,Daizo Saito,Masahiro Tada,Hiroyasu Iishi,Satoshi Tanabe,Tsuneo Oyama,Toshihiko Doi,Yoshihide Otani,Junko Fujisaki,Yoichi Ajioka,Tsutomu Hamada,Haruhiro Inoue,Takuji Gotoda,Shigeaki Yoshida.A multicenter retrospective study of endoscopic resection for early gastric cancer[J]. Gastric Cancer . 2006 (4)
  • 7C. Kunisaki,M. Takahashi,Y. Nagahori,T. Fukushima,H. Makino,R. Takagawa,T. Kosaka,H. Ono,H. Akiyama,Y. Moriwaki,A. Nakano.Risk factors for lymph node metastasis in histologically poorly differentiated type early gastric cancer[J]. Endoscopy . 2009 (06)
  • 8Kim Kyu-Jong,Park Seun Ja,Moon Won.Analysis of factors related to lymph node metastasis in undifferentiated early gastric cancer. TURKISH JOURNAL OF GASTROENTEROLOGY . 2011
  • 9Ono H,Kondo H,Gotoda T,et al.Endoscopic mucosal resection for treatment of early gastric cancer. Gut . 2001
  • 10Chizu Yokoi,Takuji Gotoda,Hisanao Hamanaka,Ichiro Oda.??Endoscopic submucosal dissection allows curative resection of locally recurrent early gastric cancer after prior endoscopic mucosal resection(J)Gastrointestinal Endoscopy . 2006 (2)

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