PMID- 26344882
OWN - NLM
STAT- MEDLINE
DCOM- 20170112
LR  - 20170113
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 83
IP  - 5
DP  - 2016 May
TI  - The risk of lymph node metastases in 3951 surgically resected mucosal gastric
      cancers: implications for endoscopic resection.
PG  - 896-901
LID - 10.1016/j.gie.2015.08.051 [doi]
LID - S0016-5107(15)02823-0 [pii]
AB  - BACKGROUND AND AIMS: Endoscopic resection for mucosal gastric cancer (MGC) is
      highly recommended in the absence of lymph node metastasis (LNM). We aimed to
      clarify the risk factors for LNM in MGC and to investigate the association of LNM
      with the indication criteria for endoscopic submucosal dissection (ESD). METHODS:
      A retrospective cohort study was performed on 3951 patients with MGC who
      underwent radical gastrectomy at the Samsung Medical Center in Seoul, Republic of
      Korea, between September 1994 and September 2010. RESULTS: Of the patients with
      MGC, 101 (2.60%) were positive for LNM. Multivariate analysis, followed by
      univariate analysis, revealed the following risk factors for LNM in MGC: large
      tumor size, undifferentiated tumor type, lymphatic invasion, perineural invasion,
      and associated ulceration in the tumor (hazard ratio 1.25, 7.49, 20.65, 23.45,
      and 4.07, respectively). Patients without LNM had significantly increased
      survival and/or recurrence-free survival rates than patients with LNM
      (188.4/209.8 months vs 169.5/188.0 months; P = .029/.004, respectively). Only 3
      of 1065 patients (0.3%) who met the absolute indication criteria for ESD had LNM.
      Of those who met the expanded indication criteria for ESD, 11 of 2678 patients
      (0.4%) had LNM. LNM also was found in 2 patients who had a differentiated tumor
      <0.5 cm without ulceration. CONCLUSION: The risk for LNM was very low when
      patients with MGC met the absolute and/or expanded criteria for endoscopic
      resection, which meant the indication criteria for ESD was safe and acceptable.
      However, although the risk for LNM is very low, it should not be considered
      negligible in endoscopic resection.
CI  - Copyright (c) 2016 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Choi, Kang Kook
AU  - Choi KK
AD  - Department of Trauma Surgery, Regional Trauma Center, Gachon Gil Hospital,
      Incheon, Republic of Korea.
FAU - Bae, Jae Moon
AU  - Bae JM
AD  - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Republic of Korea.
FAU - Kim, Su Mi
AU  - Kim SM
AD  - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Republic of Korea.
FAU - Sohn, Tae Sung
AU  - Sohn TS
AD  - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Republic of Korea.
FAU - Noh, Jae Hyung
AU  - Noh JH
AD  - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Republic of Korea.
FAU - Lee, Jun Ho
AU  - Lee JH
AD  - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Republic of Korea.
FAU - Choi, Min-Gew
AU  - Choi MG
AD  - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Republic of Korea.
FAU - Kim, Sung
AU  - Kim S
AD  - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Republic of Korea.
LA  - eng
PT  - Journal Article
DEP - 20150903
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2016 May;83(5):902-4. PMID: 27102527
MH  - Adenocarcinoma/*secondary/*surgery
MH  - Adult
MH  - Aged
MH  - Blood Vessels/pathology
MH  - Disease-Free Survival
MH  - Dissection
MH  - Female
MH  - Gastric Mucosa/surgery
MH  - Gastroscopy
MH  - Humans
MH  - Lymph Nodes/*pathology
MH  - Lymphatic Metastasis
MH  - Lymphatic Vessels/pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Grading
MH  - Neoplasm Invasiveness
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stomach Neoplasms/*pathology/*surgery
MH  - Survival Rate
MH  - Tumor Burden
EDAT- 2015/09/08 06:00
MHDA- 2017/01/14 06:00
CRDT- 2015/09/08 06:00
PHST- 2015/04/15 00:00 [received]
PHST- 2015/08/06 00:00 [accepted]
PHST- 2015/09/08 06:00 [entrez]
PHST- 2015/09/08 06:00 [pubmed]
PHST- 2017/01/14 06:00 [medline]
AID - S0016-5107(15)02823-0 [pii]
AID - 10.1016/j.gie.2015.08.051 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2016 May;83(5):896-901. doi: 10.1016/j.gie.2015.08.051. Epub
      2015 Sep 3.