Risk of Lymph Node Metastasis and Feasibility of Endoscopic Treatment in Ulcerative Early Gastric Cancer

Background When the risk of lymph node metastasis (LNM) is considered minimal in patients with early gastric cancer (EGC), endoscopic submucosal dissection (ESD) is an effective alternative to radical resection. This study aims to estimate the feasibility of ESD for EGC with ulceration. Patients and...

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Bibliographic Details
Published in:Annals of surgical oncology 2021-04, Vol.28 (4), p.2407-2417
Main Authors: Ren, Ming-Han, Qi, Xing-Si, Chu, Yu-Ning, Yu, Ya-Nan, Chen, Yun-Qing, Zhang, Peng, Mao, Tao, Tian, Zi-Bin
Format: Article
Language:English
Subjects:
Endoscopy
Feasibility Studies
Gastrectomy
Gastric cancer
Gastric Mucosa
Gastrointestinal Oncology
Humans
Lesions
Lymph Node Excision
Lymph nodes
Lymphatic Metastasis
Lymphatic system
Medicine
Medicine & Public Health
Metastases
Metastasis
Mucosa
Multivariate analysis
Neoplasm Invasiveness
Oncology
Retrospective Studies
Risk Factors
Stomach Neoplasms - surgery
Surgery
Surgical Oncology
Tumors
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Summary:Background When the risk of lymph node metastasis (LNM) is considered minimal in patients with early gastric cancer (EGC), endoscopic submucosal dissection (ESD) is an effective alternative to radical resection. This study aims to estimate the feasibility of ESD for EGC with ulceration. Patients and Methods We retrospectively reviewed data from 691 patients who underwent gastrectomy for EGC with ulceration. Subsequently, a stratification system for lesions was created based on the expanded ESD criteria, and the associations between the subgroups and the rate of LNM were analyzed. Results LNM was confirmed in 16.5% (114/691) of patients. Univariate analysis demonstrated that age, sex, tumor size, macroscopic features, depth of invasion, tumor differentiation, Lauren type, lymphovascular invasion (LVI), and perineural invasion were associated with LNM. Multivariate analysis showed that LVI [odds ratio (OR) = 16.761 , P 
ISSN:1068-9265
1534-4681
1534-4681
DOI:10.1245/s10434-020-09153-7