Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection

A retrospective cohort analysis

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Endoscopic resection (ER) has been widely accepted as the standard treatment for early gastric cancer (EGC). However, in patients considered to have undergone non-curative ER due to their potential risk of lymph node metastasis (LNM), additional gastrectomy is recommended. The aim of the present study was to identify EGC patients after non-curative ER at high risk of LNM. Methods: A total of 150 patients who had undergone ER for EGC were diagnosed as non-curative ER due to their potential risk of LNM. Clinicopathological data and clinical outcomes were examined retrospectively. Results: Additional gastrectomy with lymph node dissection was performed in 73 patients, and the remaining 77 patients were followed-up without additional gastrectomy. In patients who underwent additional gastrectomy, 8 patients had local residual tumor, and 8 patients had LNM, which were limited in the peritumoral nodes. Only lymphatic invasion (p = 0.012) was a statistically significant factor for LNM. The 5-year overall survival and recurrence-free survival were not significantly different between patients with and without additional gastrectomy. Conclusion: Additional gastrectomy with lymph node dissection is recommended for patients who were diagnosed as non-curative ER with lymphatic invasion, and minimizing the extent of lymph node dissection may be allowed for these patients.

Original languageEnglish
Article number72
JournalBMC Surgery
Volume17
Issue number1
DOIs
Publication statusPublished - Jun 20 2017

Fingerprint

Lymph Node Excision
Stomach Neoplasms
Cohort Studies
Gastrectomy
Lymph Nodes
Neoplasm Metastasis
Survival
Residual Neoplasm
Recurrence

Keywords

  • Early gastric cancer
  • Endoscopic resection
  • Lymph node metastasis

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: A retrospective cohort analysis",
abstract = "Background: Endoscopic resection (ER) has been widely accepted as the standard treatment for early gastric cancer (EGC). However, in patients considered to have undergone non-curative ER due to their potential risk of lymph node metastasis (LNM), additional gastrectomy is recommended. The aim of the present study was to identify EGC patients after non-curative ER at high risk of LNM. Methods: A total of 150 patients who had undergone ER for EGC were diagnosed as non-curative ER due to their potential risk of LNM. Clinicopathological data and clinical outcomes were examined retrospectively. Results: Additional gastrectomy with lymph node dissection was performed in 73 patients, and the remaining 77 patients were followed-up without additional gastrectomy. In patients who underwent additional gastrectomy, 8 patients had local residual tumor, and 8 patients had LNM, which were limited in the peritumoral nodes. Only lymphatic invasion (p = 0.012) was a statistically significant factor for LNM. The 5-year overall survival and recurrence-free survival were not significantly different between patients with and without additional gastrectomy. Conclusion: Additional gastrectomy with lymph node dissection is recommended for patients who were diagnosed as non-curative ER with lymphatic invasion, and minimizing the extent of lymph node dissection may be allowed for these patients.",
keywords = "Early gastric cancer, Endoscopic resection, Lymph node metastasis",
author = "Satoru Kikuchi and Shinji Kuroda and Masahiko Nishizaki and Tetsuya Kagawa and Hiromitsu Kanzaki and Yoshiro Kawahara and Shunsuke Kagawa and Takehiro Tanaka and Hiroyuki Okada and Toshiyoshi Fujiwara",
year = "2017",
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T1 - Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection

T2 - A retrospective cohort analysis

AU - Kikuchi, Satoru

AU - Kuroda, Shinji

AU - Nishizaki, Masahiko

AU - Kagawa, Tetsuya

AU - Kanzaki, Hiromitsu

AU - Kawahara, Yoshiro

AU - Kagawa, Shunsuke

AU - Tanaka, Takehiro

AU - Okada, Hiroyuki

AU - Fujiwara, Toshiyoshi

PY - 2017/6/20

Y1 - 2017/6/20

N2 - Background: Endoscopic resection (ER) has been widely accepted as the standard treatment for early gastric cancer (EGC). However, in patients considered to have undergone non-curative ER due to their potential risk of lymph node metastasis (LNM), additional gastrectomy is recommended. The aim of the present study was to identify EGC patients after non-curative ER at high risk of LNM. Methods: A total of 150 patients who had undergone ER for EGC were diagnosed as non-curative ER due to their potential risk of LNM. Clinicopathological data and clinical outcomes were examined retrospectively. Results: Additional gastrectomy with lymph node dissection was performed in 73 patients, and the remaining 77 patients were followed-up without additional gastrectomy. In patients who underwent additional gastrectomy, 8 patients had local residual tumor, and 8 patients had LNM, which were limited in the peritumoral nodes. Only lymphatic invasion (p = 0.012) was a statistically significant factor for LNM. The 5-year overall survival and recurrence-free survival were not significantly different between patients with and without additional gastrectomy. Conclusion: Additional gastrectomy with lymph node dissection is recommended for patients who were diagnosed as non-curative ER with lymphatic invasion, and minimizing the extent of lymph node dissection may be allowed for these patients.

AB - Background: Endoscopic resection (ER) has been widely accepted as the standard treatment for early gastric cancer (EGC). However, in patients considered to have undergone non-curative ER due to their potential risk of lymph node metastasis (LNM), additional gastrectomy is recommended. The aim of the present study was to identify EGC patients after non-curative ER at high risk of LNM. Methods: A total of 150 patients who had undergone ER for EGC were diagnosed as non-curative ER due to their potential risk of LNM. Clinicopathological data and clinical outcomes were examined retrospectively. Results: Additional gastrectomy with lymph node dissection was performed in 73 patients, and the remaining 77 patients were followed-up without additional gastrectomy. In patients who underwent additional gastrectomy, 8 patients had local residual tumor, and 8 patients had LNM, which were limited in the peritumoral nodes. Only lymphatic invasion (p = 0.012) was a statistically significant factor for LNM. The 5-year overall survival and recurrence-free survival were not significantly different between patients with and without additional gastrectomy. Conclusion: Additional gastrectomy with lymph node dissection is recommended for patients who were diagnosed as non-curative ER with lymphatic invasion, and minimizing the extent of lymph node dissection may be allowed for these patients.

KW - Early gastric cancer

KW - Endoscopic resection

KW - Lymph node metastasis

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