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Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis

BACKGROUND: Endoscopic resection (ER) has been widely accepted as the standard treatment for early gastric cancer (EGC). However, in patients considered to have undergone non-curative ER due to their potential risk of lymph node metastasis (LNM), additional gastrectomy is recommended. The aim of the...

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Autores principales: Kikuchi, Satoru, Kuroda, Shinji, Nishizaki, Masahiko, Kagawa, Tetsuya, Kanzaki, Hiromitsu, Kawahara, Yoshiro, Kagawa, Shunsuke, Tanaka, Takehiro, Okada, Hiroyuki, Fujiwara, Toshiyoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5480174/
https://www.ncbi.nlm.nih.gov/pubmed/28637436
http://dx.doi.org/10.1186/s12893-017-0268-0
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author Kikuchi, Satoru
Kuroda, Shinji
Nishizaki, Masahiko
Kagawa, Tetsuya
Kanzaki, Hiromitsu
Kawahara, Yoshiro
Kagawa, Shunsuke
Tanaka, Takehiro
Okada, Hiroyuki
Fujiwara, Toshiyoshi
author_facet Kikuchi, Satoru
Kuroda, Shinji
Nishizaki, Masahiko
Kagawa, Tetsuya
Kanzaki, Hiromitsu
Kawahara, Yoshiro
Kagawa, Shunsuke
Tanaka, Takehiro
Okada, Hiroyuki
Fujiwara, Toshiyoshi
author_sort Kikuchi, Satoru
collection PubMed
description BACKGROUND: Endoscopic resection (ER) has been widely accepted as the standard treatment for early gastric cancer (EGC). However, in patients considered to have undergone non-curative ER due to their potential risk of lymph node metastasis (LNM), additional gastrectomy is recommended. The aim of the present study was to identify EGC patients after non-curative ER at high risk of LNM. METHODS: A total of 150 patients who had undergone ER for EGC were diagnosed as non-curative ER due to their potential risk of LNM. Clinicopathological data and clinical outcomes were examined retrospectively. RESULTS: Additional gastrectomy with lymph node dissection was performed in 73 patients, and the remaining 77 patients were followed-up without additional gastrectomy. In patients who underwent additional gastrectomy, 8 patients had local residual tumor, and 8 patients had LNM, which were limited in the peritumoral nodes. Only lymphatic invasion (p = 0.012) was a statistically significant factor for LNM. The 5-year overall survival and recurrence-free survival were not significantly different between patients with and without additional gastrectomy. CONCLUSION: Additional gastrectomy with lymph node dissection is recommended for patients who were diagnosed as non-curative ER with lymphatic invasion, and minimizing the extent of lymph node dissection may be allowed for these patients.
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spelling pubmed-54801742017-06-23 Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis Kikuchi, Satoru Kuroda, Shinji Nishizaki, Masahiko Kagawa, Tetsuya Kanzaki, Hiromitsu Kawahara, Yoshiro Kagawa, Shunsuke Tanaka, Takehiro Okada, Hiroyuki Fujiwara, Toshiyoshi BMC Surg Research Article BACKGROUND: Endoscopic resection (ER) has been widely accepted as the standard treatment for early gastric cancer (EGC). However, in patients considered to have undergone non-curative ER due to their potential risk of lymph node metastasis (LNM), additional gastrectomy is recommended. The aim of the present study was to identify EGC patients after non-curative ER at high risk of LNM. METHODS: A total of 150 patients who had undergone ER for EGC were diagnosed as non-curative ER due to their potential risk of LNM. Clinicopathological data and clinical outcomes were examined retrospectively. RESULTS: Additional gastrectomy with lymph node dissection was performed in 73 patients, and the remaining 77 patients were followed-up without additional gastrectomy. In patients who underwent additional gastrectomy, 8 patients had local residual tumor, and 8 patients had LNM, which were limited in the peritumoral nodes. Only lymphatic invasion (p = 0.012) was a statistically significant factor for LNM. The 5-year overall survival and recurrence-free survival were not significantly different between patients with and without additional gastrectomy. CONCLUSION: Additional gastrectomy with lymph node dissection is recommended for patients who were diagnosed as non-curative ER with lymphatic invasion, and minimizing the extent of lymph node dissection may be allowed for these patients. BioMed Central 2017-06-20 /pmc/articles/PMC5480174/ /pubmed/28637436 http://dx.doi.org/10.1186/s12893-017-0268-0 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kikuchi, Satoru
Kuroda, Shinji
Nishizaki, Masahiko
Kagawa, Tetsuya
Kanzaki, Hiromitsu
Kawahara, Yoshiro
Kagawa, Shunsuke
Tanaka, Takehiro
Okada, Hiroyuki
Fujiwara, Toshiyoshi
Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis
title Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis
title_full Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis
title_fullStr Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis
title_full_unstemmed Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis
title_short Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis
title_sort management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5480174/
https://www.ncbi.nlm.nih.gov/pubmed/28637436
http://dx.doi.org/10.1186/s12893-017-0268-0
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