Risk Factors for Lymph Node Metastasis in Undifferentiated Early Gastric Cancer

Li, Chen; Kim, Sung Soo; Lai, Ji Fu; Oh, Sung Jin; Hyung, Woo Jin; Choi, Won Hyuk; Choi, Seung Ho; Zhu, Zheng; Noh, Sung Hoon

doi:10.1245/s10434-007-9707-y

Cited by 71 publications

(55 citation statements)

References 17 publications

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“…Some have asserted that outcome and longterm prognosis were equivalent to those of the standard indication group as long as several conditions are met, and therefore endoscopic resection can be performed (15). In our study, the LNM rate of undifferentiated EGC was 8.5%, that is, 3.5% in mucosal EGC and 15% in submucosal EGC, which is similar to other studies (10). Undifferentiated EGC has a higher LNM rate than differentiated EGC as described above, but approximately 97% of patients with mucosal EGC without LNM have been receiving unnecessary surgery, which can reduce their quality of life.…”

Section: Discussionsupporting

confidence: 89%

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Analysis of factors related to lymph node metastasis in undifferentiated early gastric cancer

Kim

Park²,

Moon³

et al. 2011

Turk J Gastroenterol

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Amaç: Bu çal›flmada erken gastrik kanserde lenf nodu metastaz› ile iliflkili faktörlerin araflt›r›lmas› ve endoskopik rezeksiyona uygunlu¤un araflt›r›lmas› amaçlanm›flt›r. Yöntem: Erken kötü differansiye gastrik kanseri olan ve cerrahi uygulanm›fl 362 hasta ça-l›flmaya dahil edilmifl ve hastalar yafl, cinsiyet, tümör lokalizasyonu, makroskopik bulgular, ülser varl›¤›, histolojik tip, tümör boyutu, invazyon

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Section: Discussionsupporting

confidence: 89%

“…Some have tried to include undifferentiated EGC in the expanded indication for endoscopic resection (9); however, since LNM has not been reported in most cases who underwent operation, uniform application of operation may be regarded as overtreatment (10).…”

Section: Introductionmentioning

confidence: 99%

Analysis of factors related to lymph node metastasis in undifferentiated early gastric cancer

Kim

Park²,

Moon³

et al. 2011

Turk J Gastroenterol

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“…The upper limit of the 95% confi dence interval was 2.6%, which was considered to be suffi ciently large to exclude the possibility of lymph node metastasis. Some predictive factors for lymph node metastasis in undifferentiated EGC have been reported [7][8][9][10][11]. Previously, we retrospectively examined factors predictive of lymph node metastasis in 332 patients with undifferentiated EGC who underwent gastrectomy, including the present patient.…”

Section: Discussionmentioning

confidence: 91%

A case of small undifferentiated intramucosal gastric cancer with lymph node metastasis

et al. 2010

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include larger, differentiated intramucosal adenocarcinoma and undifferentiated adenocarcinoma less than 20 mm in diameter and without ulceration. Case reportA 60-year-old Japanese woman visited a local hospital because of anorexia and body weight loss, and gastroscopy revealed gastric cancer. She was admitted to our hospital for the treatment of gastric cancer in October 2001. She had no history of malignant disease and no family history of cancer. Upper gastrointestinal endoscopy revealed irregular, depressed mucosa, type 0 IIc in accordance with the Japanese classifi cation of gastric carcinoma (JCGC) [4] in the large curvature of the lower gastric body (Fig. 1). The diameter was approximately 1 cm, and there were no ulcer fi ndings. Endoscopic ultrasonography revealed this to be an intramucosal cancer, and computed tomography examination showed no distinct lymph node metastasis. Pathologically, signet-ring cell carcinoma was detected in the biopsy specimen. Laboratory results were within normal limits, and serum carcinoembryonic antigen (CEA) levels were normal. Wedge resection of the stomach with resection of a single lymph node (#4d) was performed in November 2001 (Fig. 2). Histological examination revealed that signet-ring cell carcinoma was located in approximately one-third of the superficial portion of the mucosal layer and that carcinoma cells had not invaded into the muscularis mucosa (Fig. 3A, B). The tumor was 13 mm in size. No lymphatic invasion, venous invasion (immunohistochemical staining with CD34 and D2-40), or ulcer scar was observed in the submucosal layer. Histologically, there was no fi brosis in the submucosal layer and no breakdown of the muscularis mucosa. The resection margin was clear of tumor cells. The single resected lymph node had metastatic cancer cells; these were also signet-ring cell car-

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“…Clinicopathological characteristics according to SDF-1α expression. nostic factor for EGC as the 5-year survival rate of patients without lymph node metastasis is approximately 95%, whereas that of patients with metastasis is approximately 83% (7,20). Therefore, a number of studies have been conducted to identify predictive parameters, particularly biological markers, of lymph node metastasis in EGC.…”

Section: Discussionmentioning

confidence: 99%

Expression of stromal cell-derived factor-1α is an independent risk factor for lymph node metastasis in early gastric cancer

Song¹,

Liang²,

Lee³

et al. 2011

Oncology Letters

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Abstract. Lymph node metastasis is considered to be a significant prognostic factor for early gastric cancer (EGC). However, no real consensus exists on which patient and/ or tumor characteristics are associated with lymph node metastasis. We investigated whether stromal cell-derived factor (SDF)-1α expression correlates with lymph node metastasis in patients with EGC by immunohistochemically examining the expression of SDF-1α in 138 archival tissue specimens of EGC. Of these specimens, 59 (42.8%) and 79 (57.2%) were grouped into SDF-1α-positive and SDF-1α-negative groups, respectively. No significant differences existed with respect to age, gender, tumor location, proportion of tumors >20 mm in size, macroscopic type, depth of invasion or histology between the SDF-1α-positive and -negative groups. However, the SDF-1α-positive group was significantly correlated with lymphovascular invasion and lymph node metastasis. Results of the univariate analyses indicated that lymphovascular invasion, undifferentiated histology and SDF-1α positivity were statistically significant risk factors affecting lymph node metastasis in patients with EGC. Multivariate analyses showed that lymphovascular invasion [hazard ratio (HR), 8.595; 95% confidence interval (CI), 1.694-43.595; P=0.009], undifferentiated histology (HR, 2.965; 95% CI, 1.037-8.471; P=0.043) and SDF-1α positivity (HR, 2.108; 95% CI, 1.316-10.135; P=0.013) were independent risk factors predicting lymph node metastasis in EGC. In conclusion, these results suggest that SDF-1α expression in tumor cells is a predictive marker of lymph node metastasis in EGC.

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Risk Factors for Lymph Node Metastasis in Undifferentiated Early Gastric Cancer

Cited by 71 publications

References 17 publications

Analysis of factors related to lymph node metastasis in undifferentiated early gastric cancer

Analysis of factors related to lymph node metastasis in undifferentiated early gastric cancer

A case of small undifferentiated intramucosal gastric cancer with lymph node metastasis

Expression of stromal cell-derived factor-1α is an independent risk factor for lymph node metastasis in early gastric cancer

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