Defining a Subgroup Treatable for Laparoscopic and Endoscopic Cooperative Surgery in Undifferentiated Early Gastric Cancer: the Role of Lymph Node Metastasis

Li, Hua; Chen, Lin; Huo, Zhibin; Xi, Hongqing; Cui, Jianxin; Zhao, Xudong

doi:10.1007/s11605-015-2897-x

Cited by 7 publications

(4 citation statements)

References 33 publications

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“…Signet ring cell carcinoma is not more likely than differentiated carcinoma to develop LNM when it is confined to the mucosa and is <2 cm. This observation is consistent with research by Li et al [18] However, it remains to be confirmed with a larger sample size and follow-up data. It also remains controversial whether ESD can be performed on undifferentiated cancers.…”

Section: Discussionsupporting

confidence: 92%

High risk factors related to lymph node metastasis in early gastric cancer: A retrospective observational study

Fan

Shi²,

Lu³

2023

Medicine

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Lymph node metastasis (LNM) is a key factor affecting the prognosis of patients with early gastric cancer. This is a retrospective study, conducted between January 20, 2010 and January 30, 2019 and included 402 patients with early-stage gastric cancer who underwent radical gastrectomy at The Affiliated People Hospital of Ningbo University. Clinical and pathological data including patients’ gender, age, tumor location, gross typing, depth of invasion, tumor maximum diameter, type of differentiation, vascular invasion, presence or absence of signet ring cells, and LNM data were collected and analyzed. Univariate analysis identified positive relationships between patient gender, tumor invasion depth, tumor size, presence or absence of vascular involvement, and differentiation type with LNM ( P < .05). Multivariate analysis subsequently confirmed tumor size (odds ratio [OR]: 2.38, 95% confidence interval [CI]:1.15–4.92, P = .02), vascular involvement (OR: 4.35, 95% CI: 2.00–9.47, P < .001), and depth of invasion (OR: 6.63, 95% CI: 2.19–20.06, P = .001) as independent risk factors for LNM ( P < .05). Tumor size, vascular involvement, and depth of invasion are independent risk factors for LNM in cases of early-stage gastric cancer.

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Section: Discussionsupporting

confidence: 92%

High risk factors related to lymph node metastasis in early gastric cancer: A retrospective observational study

Fan

Shi²,

Lu³

2023

Medicine

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“…Other techniques (Table 3 ) have been developed to avoid spread of the tumor to the peritoneum[ 37 - 39 ]. When performed by expert teams they show a lot of promise and achieve solid oncologic results[ 40 , 41 ]. Use and standardization of these minimally invasive surgical procedures contributes to reduction of unnecessary gastrectomy for gastric submucosal tumors[ 42 ].…”

Section: Treatmentmentioning

confidence: 99%

Early gastric cancer: A challenge in Western countries

Chiarello¹,

Fico²,

Pepe³

et al. 2022

WJG

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Early gastric cancer (EGC) is an invasive carcinoma involving only the stomach mucosa or submucosa, independently of lymph node status. EGC represents over 50% of cases in Japan and in South Korea, whereas it accounts only for approximately 20% of all newly diagnosed gastric cancers in Western countries. The main classification systems of EGC are the Vienna histopathologic classification and the Paris endoscopic classification of polypoid and non-polypoid lesions. A careful endoscopic assessment is fundamental to establish the best treatment of EGC. Generally, EGCs are curable if the lesion is completely removed by endoscopic resection or surgery. Some types of EGC can be resected endoscopically; for others the most appropriate treatment is surgical resection and D2 lymphadenectomy, especially in Western countries. The favorable oncological prognosis, the extended lymphadenectomy and the reconstruction of the intestinal continuity that excludes the duodenum make the prophylactic cholecystectomy mandatory to avoid the onset of biliary complications.

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“…This may minimize postoperative complications and improve quality of life, without impairment of prognosis. [26][27][28][29] In this study, it is not surprising that older patients appear in the "Additional surgery" group, given the less invasive nature of endoscopic procedures.…”

Section: Discussionmentioning

confidence: 75%

“…This study provides indirect evidence for the possibility of minimally invasive and organ‐preserving surgery, including sentinel node navigation surgery (SNNS) in EGC of noncurative ER. This may minimize postoperative complications and improve quality of life, without impairment of prognosis . In this study, it is not surprising that older patients appear in the “Additional surgery” group, given the less invasive nature of endoscopic procedures.…”

Section: Discussionmentioning

confidence: 82%

The distribution pattern of metastatic lymph nodes after non‐curative endoscopic resection in early gastric cancer

Arroyo-Martinez

Han

Eom

et al. 2018

Journal of Surgical Oncology

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Background and Objectives Additional surgery should be done after non‐curative endoscopic resection (ER) in early gastric cancer (EGC) due to the risk of lymph node metastasis (LNM). However, the distribution pattern of LNM in these patients is complicated and unpredictable. The aim of this study is to identify any different distribution patterns of LNM in patients with EGC who underwent additional surgery after non‐curative (ER) comparing to those without ER. Methods Patients who underwent surgery for EGC between 2001 and 2016 were included. Enrolled patients were divided into two groups, those who underwent additional surgery after non‐curative ER and those who underwent direct surgery without a history of ER. Demographics, tumor characteristics and LNM distribution pattern were analyzed. Results Among 4295 patients with EGC, 404 patients had a history of preoperative ER, and 3891 patients did not. After the application of exclusion criteria, 23 (7.1%) of 322 patients undergoing additional surgery had LNM. The additional surgery group showed less LNM, fewer nodal stations and more restricted distribution pattern of LNM. Conclusions The distribution pattern of LNM in EGC is complicated. However, more restricted locoregional LNM could be expected in cases of additional surgery after non‐curative ER than after direct surgery.

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Defining a Subgroup Treatable for Laparoscopic and Endoscopic Cooperative Surgery in Undifferentiated Early Gastric Cancer: the Role of Lymph Node Metastasis

Abstract: ESD alone may be a sufficient treatment for intramucosal undifferentiated EGC if the tumor is less than 2.0 cm in size and when LVI is absent upon postoperative histological examination. LECS is feasible and safe for patients with undifferentiated EGC.

Cited by 7 publications

References 33 publications

High risk factors related to lymph node metastasis in early gastric cancer: A retrospective observational study

High risk factors related to lymph node metastasis in early gastric cancer: A retrospective observational study

Early gastric cancer: A challenge in Western countries

The distribution pattern of metastatic lymph nodes after non‐curative endoscopic resection in early gastric cancer

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