TY - JOUR
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
N1 - Funding Information:
This work was supported by JSPS Grant-in-Aid for Young Scientists B, Grant Number 16 K21185.
Publisher Copyright:
© 2017 The Author(s).
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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U2 - 10.1186/s12893-017-0268-0
DO - 10.1186/s12893-017-0268-0
M3 - Article
C2 - 28637436
AN - SCOPUS:85021120585
VL - 17
JO - BMC Surgery
JF - BMC Surgery
SN - 1471-2482
IS - 1
M1 - 72
ER -
