Long-term outcome after laparoscopic wedge resection for early gastric cancer

Nozaki, Isao; Kubo, Y; Kurita, Akira; Tanada, Minoru; Yokoyama, Nobuji; Takiyama, Wataru; Takashima, Shigemitsu

doi:10.1007/s00464-008-9795-1

Cited by 23 publications

(7 citation statements)

References 16 publications

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“…1 This minimally invasive technique can be applied for the management of EGC without the risk of lymph node metastases (LNM). [2][3][4][5][6][7][8][9] Due to the higher risk of LNM in undifferentiated EGC, the application of ESD has been limited to EGC of well or moderately differentiated histology less than 2 cm in diameter and confined to the mucosa (depth T1a) without ulceration. 10 Therefore, gastrectomy with lymphadenectomy has been considered to be an essential treatment for patients with undifferentiated EGC.…”

Section: Introductionmentioning

confidence: 99%

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

Chen

Huo

et al. 2015

Journal of Gastrointestinal Surgery

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Section: Introductionmentioning

confidence: 99%

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

Chen

Huo

et al. 2015

Journal of Gastrointestinal Surgery

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“…Gastrectomy with D1+ lymphadenectomy is the gold standard for treatment of early gastric cancer (EGC) in Japan [9]. Recently, the utility of minimally invasive treatment, such as endoscopic submucosal dissection or reduced lymphadenectomy, has been examined for patients with EGC [10,11,12]. However, the effect of local treatments without lymphadenectomy for undifferentiated-type EGC is controversial, mainly due to the incidence of LN metastasis [13,14].…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of the Extent of Lymph Node Micrometastasis in Undifferentiated-Type Early Gastric Cancer

Lee

Tanaka²,

Ohira³

et al. 2014

Oncology

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Objective: Lymph node (LN) metastasis is one of the most important prognostic factors for undifferentiated-type early gastric cancer (EGC). The aim of this study was to examine expansion of micrometastasis in regional LNs to clarify the importance of lymphadenectomy for undifferentiated-type EGC. Methods: Clinicopathological features of 307 patients with undifferentiated-type EGC who underwent gastrectomy with lymphadenectomy between 1997 and 2010 at the Department of Surgical Oncology, Osaka City University, were retrospectively reviewed. Micrometastasis in LNs was detected by immunohistochemistry using anticytokeratin antibody. Results: The incidence of LN metastasis was 1.8% in patients with mucosal (pT1a) tumors and 17.3% in those with submucosal (pT1b) tumors. Multivariate analysis revealed that lymphatic invasion and tumor depth were independently related to LN metastasis. Micrometastasis was found in 41 (13.3%) patients. Twenty-two patients with pN0 had micrometastasis in the perigastric region. Micrometastasis had spread to the area along the left gastric or common hepatic artery in 12 patients. Patients with an upgraded stage by micrometastasis had significantly worse disease-free survival. Conclusions: LN micrometastasis was observed beyond the perigastric LNs and correlated with poor outcomes in patients with undifferentiated-type EGC. These data underscore the importance of adequate lymphadenectomy for patients with undifferentiated-type EGC.

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“…Metachronous gastric tumors after resection of EGC occurred in approximately 3% of patients in a large Japanese study of 1,281 cases, but in a smaller study of patients undergoing EGC laparoscopic wedge resection, this rate reached 12%. 26 27 The main independent risk factors revealed from multivariate analysis were male gender, advanced age, invasion of the submucosa, and proximal gastrectomy. Leaving an almost entire stomach after these minor resections results in an additional risk for a second EGC that often occurs within the first two postoperative years.…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Navigation Surgery for Early Gastric Cancer: Is It a Safe Procedure in Countries with Non-Endemic Gastric Cancer Levels? A Preliminary Experience

et al. 2016

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PurposeEarly diagnosis of gastric cancer is still the exception in Western countries. In the East, as in Japan and Korea, this disease is an endemic disorder. More conservative surgical procedures are frequently performed in early gastric cancer cases in these countries where sentinel lymph node navigation surgery is becoming a safe option for some patients. This study aims to evaluate preliminary outcomes of patients with early gastric cancer who underwent sentinel node navigation surgeries in Brazil, a country with non-endemic gastric cancer levels.Materials and MethodsFrom September 2008 to March 2014, 14 out of 205 gastric cancer patients underwent sentinel lymph node navigation surgeries, which were performed using intraoperative, endoscopic, and peritumoral injection of patent blue dye.ResultsAntrectomies with Billroth I gastroduodenostomies were performed in seven patients with distal tumors. The other seven patients underwent wedge resections. Sentinel basin resections were performed in four patients, and lymphadenectomies were extended to stations 7, 8, and 9 in the other 10. Two patients received false-negative results from sentinel node biopsies, and one of those patients had micrometastasis. There was one postoperative death from liver failure in a cirrhotic patient. Another cirrhotic patient died after two years without recurrence of gastric cancer, also from liver failure. All other patients were followed-up for 13 to 79 months with no evidence of recurrence.ConclusionsSentinel lymph node navigation surgery appears to be a safe procedure in a country with non-endemic levels of gastric cancer.

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Long-term outcome after laparoscopic wedge resection for early gastric cancer

Cited by 23 publications

References 16 publications

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

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

Clinical Impact of the Extent of Lymph Node Micrometastasis in Undifferentiated-Type Early Gastric Cancer

Sentinel Lymph Node Navigation Surgery for Early Gastric Cancer: Is It a Safe Procedure in Countries with Non-Endemic Gastric Cancer Levels? A Preliminary Experience

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