Predicting the absence of lymph node metastasis of submucosal invasive gastric cancer: Expansion of the criteria for curative endoscopic resection

Scandinavian Journal of Gastroenterology 45 巻 12 号 1480-1487 頁 2010-12 発行
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タイトル ( eng )
Predicting the absence of lymph node metastasis of submucosal invasive gastric cancer: Expansion of the criteria for curative endoscopic resection
作成者
Oka Shiro
Higashiyama Makoto
Shimamoto Fumio
収録物名
Scandinavian Journal of Gastroenterology
45
12
開始ページ 1480
終了ページ 1487
抄録
Objective. The conditions upon which endoscopic resection (ER) can be considered curative for submucosal invasive gastric cancer remain controversial; thus, unnecessary surgery is sometimes performed after ER. Our purpose is to evaluate the significance of several clinicopathological factors for predicting the absence of lymph node (LN) metastasis of submucosal invasive gastric cancer and thus determining cases in which ER can be considered curative.

Patients and methods. The study group comprised 220 patients with submucosal invasive gastric cancer that was resected surgically or endoscopically. Patients treated by ER underwent additional surgical resection. The presence of LN metastasis was evaluated in all patients, retrospectively.

Results. LN metastasis was detected in 37 (16.8%) of the 220 patients. Independent risk factors for LN metastasis were width of submucosal invasion >6000 mu m, lymphatic involvement, undifferentiated type at the deepest invasive portion, depth of submucosal invasion >1000 mu m, and tumor diameter >30 mm. The group of 36 patients with submucosal invasion to a depth of <= 1000 mu m, tumor diameter <= 30 mm, differentiated type as the dominant histologic type, and absence of vessel involvement was entirely free of LN metastasis (95% confidence interval, 0-8.0%).

Conclusions. Taken together, the five independent risk factors may allow expansion of the criteria for determining whether ER for submucosal invasive gastric cancer has been curative.
著者キーワード
Endoscopic resection
ESD
lymph node metastasis
submucosal invasive gastric cancer
NDC分類
医学 [ 490 ]
言語
英語
資源タイプ 学術雑誌論文
出版者
Taylor & Francis AS
発行日 2010-12
権利情報
Copyright (c) 2010 Informa Plc.
出版タイプ Author’s Original(十分な品質であるとして、著者から正式な査読に提出される版)
アクセス権 オープンアクセス
収録物識別子
[ISSN] 0036-5521
[DOI] 10.3109/00365521.2010.505659
[NCID] AA00833522
[DOI] http://dx.doi.org/10.3109/00365521.2010.505659