Risk Stratification According to the Total Number of Factors That Meet the Indication Criteria for Radical Lymph Node Dissection in Patients with Early Gastric Cancer at Risk for Lymph Node Metastasis

Background Extended indications for endoscopic resection for early gastric cancer (EGC) have been widely accepted. However, according to current guidelines, additional gastrectomy with lymph node dissection (LND) is recommended for patients proven to have potential risks of lymph node metastasis (LN...

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Published in:Annals of surgical oncology 2016-12, Vol.23 (Suppl 5), p.792-797
Main Authors: Shoda, Katsutoshi, Ichikawa, Daisuke, Arita, Tomohiro, Kosuga, Toshiyuki, Konishi, Hirotaka, Morimura, Ryo, Murayama, Yasutoshi, Komatsu, Shuhei, Shiozaki, Atsushi, Kuriu, Yoshiaki, Ikoma, Hisashi, Nakanishi, Masayoshi, Fujiwara, Hitoshi, Okamoto, Kazuma, Otsuji, Eigo
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Blood Vessels - pathology
Disease-Free Survival
Endoscopic Mucosal Resection
Female
Gastrectomy
Gastrointestinal Oncology
Humans
Lymph Node Excision
Lymphatic Metastasis
Lymphatic Vessels - pathology
Male
Margins of Excision
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Grading
Neoplasm Invasiveness
Oncology
Patient Selection
Retrospective Studies
Risk Assessment - methods
Risk Factors
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Surgery
Surgical Oncology
Survival Rate
Tumor Burden
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Summary:Background Extended indications for endoscopic resection for early gastric cancer (EGC) have been widely accepted. However, according to current guidelines, additional gastrectomy with lymph node dissection (LND) is recommended for patients proven to have potential risks of lymph node metastasis (LNM) on histopathological findings. The aim of this study was to elucidate the risk stratification of outcome and LNM according to the number of factors that meet the inclusion criteria for radical LND for possible LNM (LNM risk factors) in patients with negative endoscopic resection margin. Methods We enrolled 511 EGC patients whose tumors did not meet the absolute or extended indications for endoscopic resection, and investigated the risk stratification of prognosis and LNM according to the total number of LNM risk factors. Results Recurrence-free and overall survival rates were significantly higher in patients with fewer LNM risk factors for surgical indication ( p  = 0.0274 and 0.0002, respectively; log-rank test), and the total number of LNM risk factors and frequency of LNM were significantly correlated ( p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-016-5553-0