The Risk Factors of Lymph Node Metastasis in Early Gastric Cancer

Pathology & Oncology Research

Yee Chao²  Anna Fen-Yau Li²  Su-Shun Lo³  Yuan-Tzu Lan²  Yi-Ming Shyr²  Chew-Wun Wu²  Kuo-Hung Huang¹  Wen-Liang Fang²  Ming-Huang Chen² 

[1] Taipei Veterans General Hospital$$National Yang-Ming University$$National Yang-Ming University$$;Taipei Veterans General Hospital$$National Yang-Ming University$$;National Yang-Ming University$$National Yang-Ming University Hospital$$

关键词: Lymphatic invasion;   

DOI  :  10.1007/s12253-015-9920-0

学科分类：生理学与病理学

来源: Springer

【 摘 要 】

Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) is an effective alternative treatment for early gastric cancer. However, a major concern is the likelihood of lymph node metastasis. From December 1987 to December 2006, 391 patients who underwent curative surgery for gastric cancer with mucosal (T1a, n�?=�?265) or submucosal (T1b, n�?=�?126) invasion and a retrieved lymph node number�?15 were enrolled. The frequency and risk factors of lymph node metastasis were analyzed. The frequency of lymph node metastasis was 4.9 % in T1a lesions and 21.4 % in T1b lesions. Although the depth of submucosal tumor invasion was�?<�?2 mm, there was a 28.6 % chance of lymph node metastasis. A T1b lesion, i.e., the width of the submucosal tumor invasion was�?<�?5 mm, resulted in fewer lymph node metastases than lesions�?>�?5 mm in width. Multivariate analysis demonstrated that Lauren’s diffuse type and lymphatic invasion were independent risk factors for lymph node metastasis in T1a lesions, while lymphatic invasion was the strongest risk factor for lymph node metastasis in T1b lesions. EMR/ESD is a good alternative for T1a intestinal type adenocarcinoma without lymphatic invasion. Surgical resection is necessary for patients with T1b gastric cancer with lymphatic invasion.

【 授权许可】

Unknown