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

BMC Surgery

Research Article

Takehiro Tanaka¹  Hiromitsu Kanzaki²  Yoshiro Kawahara²  Tetsuya Kagawa³  Shunsuke Kagawa³  Masahiko Nishizaki³  Shinji Kuroda³  Satoru Kikuchi³  Toshiyoshi Fujiwara³  Hiroyuki Okada⁴ 

[1] Department of Diagnostic Pathology, Okayama University Hospital, 700-8558, Okayama, Japan;Department of Endoscopy, Okayama University Hospital, 700-8558, Okayama, Japan;Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, 700-8558, Okayama, Japan;Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 700-8558, Okayama, Japan;

关键词: Early gastric cancer;    Endoscopic resection;    Lymph node metastasis;   

DOI  :  10.1186/s12893-017-0268-0

 received in 2017-01-17, accepted in 2017-06-15,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundEndoscopic 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.MethodsA 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.ResultsAdditional 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.ConclusionAdditional 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.

【 授权许可】

CC BY   
© The Author(s). 2017