Risk factors of lymph node metastasis after non-curative endoscopic resection of undifferentiated-type early gastric cancer
- 주제(키워드) Lymph node Metastasis , Non-curative resection , Risk factors , Stomach neoplasms , Undifferentiated-type histology
- 등재 SCIE, SCOPUS
- OA유형 Bronze
- 발행기관 Springer Japan
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000175340
- 본문언어 영어
- Published As http://dx.doi.org/10.1007/s10120-020-01103-2
- PubMed https://pubmed.ncbi.nlm.nih.gov/32623585
- 저작권 이화여자대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Background: This study aimed to investigate risk factors for lymph node (LN) or distant metastasis after non-curative endoscopic resection (ER) of undifferentiated-type early gastric cancer (EGC). Methods: Of 1124 patients who underwent ER for undifferentiated-type gastric cancer at 18 tertiary hospitals across six geographic areas in Korea between 2005 and 2014, 634 with non-curative ER beyond the expanded criteria were retrospectively enrolled. According to the treatment after ER, patients were divided into additional surgery (n = 270) and follow-up (n = 364) groups. The median follow-up duration was 59 months for recurrence and 84 months for mortality. Results: LN metastasis was found in 6.7% (18/270) of patients at surgery. Ulcer [odds ratio (OR) 3.83; 95% confidence interval (CI) 1.21–12.13; p = 0.022] and submucosal invasion (OR 10.35; 95% CI 1.35–79.48; p = 0.025) were independent risk factors. In the follow-up group, seven patients (1.9%) developed LN or distant recurrence. Ulcer [hazard ratio (HR) 7.60; 95% CI 1.39–35.74; p = 0.018], LVI (HR 6.80; 95% CI 1.07–42.99; p = 0.042), and positive vertical margin (HR 6.71; 95% CI 1.28–35.19; p = 0.024) were independent risk factors. In the overall cohort, LN metastasis rates were 9.6% in patients with two or more risk factors and 1.2% in those with no or one risk factor. Conclusions: LVI, ulcer, submucosal invasion, and positive vertical margin are independently associated with LN or distant metastasis after non-curative ER of undifferentiated-type EGC. Surgical resection is strongly recommended for patients with two or more risk factors. © 2020, The International Gastric Cancer Association and The Japanese Gastric Cancer Association.
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