Failure ofHelicobacter pylorieradication and age are independent risk factors for recurrent neoplasia after endoscopic resection of early gastric cancer in 283 patients

Abstract Objective To investigate the effect of Helicobacter pylori (H. pylori) eradication on the prognosis of postoperative early gastric cancer (EGC). Methods This is a retrospective study based on data from 6 hospitals. We identified 429 patients with EGC who underwent curative gastrectomy from January 2010 to December 2016. All of the patients were tested for H. pylori. Patients were divided into two groups, the successful H. pylori eradication group (group A, 268 patients) and the non-H. pylori eradication group (group B, 161 patients), for calculating the disease-free survival (DFS) and overall survival (OS) of each group. Result Positive node metastasis (hazard ratio (HR), 3.13; 95% confidence interval (CI), 1.84–5.32; P < 0.001), undifferentiated type (HR, 2.54; 95% CI, 1.51–4.28; P < 0.001), and non-H. pylori eradication (HR, 1.73; 95% CI, 1.08–2.77; P = 0.023) were statistically significantly independent risk factors of recurrence. Patient’s age ≥60 years old (HR, 3.32; 95% CI, 2.00–5.53; P < 0.001), positive node metastasis (HR, 3.71; 95% CI, 2.25–6.12; P < 0.001), undifferentiated type (HR, 3.06; 95% CI, 1.79–5.23; P < 0.001), and non-H. pylori eradication (HR, 1.83; 95% CI, 1.11–3.02; P = 0.018) were statistically significantly independent risk factors of overall survival. Conclusion H. pylori eradication treatment could prevent the recurrence of postoperative EGC to prolong the overall survival of patients with EGC.

Download Full-text

Sa1656 Risk Factors for Residual or Recurrent Tumor in Patients With Pathologically Positive Resection Margins After Endoscopic Resection of Early Gastric Cancer

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2012.04.177 ◽

2012 ◽

Vol 75 (4) ◽

pp. AB235

Author(s):

Hyuk Yoon ◽

Sang Gyun Kim ◽

Jeongmin Choi ◽

Jong Pil Im ◽

Joo Sung Kim ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Early Gastric Cancer ◽

Endoscopic Resection ◽

Resection Margins ◽

Recurrent Tumor ◽

Positive Resection Margins

Download Full-text

Risk Factors for Lymph Node Involvement of Early Gastric Cancer. Indications of Endoscopic Resection.

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.27.17 ◽

1994 ◽

Vol 27 (1) ◽

pp. 17-22

Author(s):

Shingo Yagi ◽

Takuhisa Kawakami ◽

Matsuhei Tanaka ◽

Kouichi Yokoyama ◽

Yasuhiko Tatsuzawa ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Early Gastric Cancer ◽

Endoscopic Resection ◽

Lymph Node Involvement ◽

Node Involvement

Download Full-text

Feasibility of endoscopic resection in early gastric cancer with lymphovascular invasion.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.87 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 87-87

Author(s):

Jun Haeng Lee ◽

Hyuk Lee ◽

Jae J Kim

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Early Gastric Cancer ◽

Endoscopic Resection ◽

Survival Data ◽

Lymphovascular Invasion ◽

Additional Surgery ◽

Significant Difference ◽

Undifferentiated Histology ◽

The Absolute

87 Background: Lymphovascular invasion (LVI) is associated with the risk of lymph node metastasis (LNM) and poor survival in gastric cancer patients. However, it is unclear whether LVI is a noncurative criteria component in all patients. We evaluated the risk factors of LNM in LVI-positive early gastric cancer (EGC) patients and identified a subgroup with a negligible LNM risk to assess the feasibility of endoscopic resection in these patients. Methods: The clinicopathologic and survival data of patients undergoing surgery for gastric cancer were reviewed; LVI-positive EGC patients were selected. Logistic regression analysis was used to test the associations of potential risk factors with LNM; Kaplan-Meier analysis was used to compare survival curves. Results: LVI was detected in 1,243 (15.5%) patients. In the multivariate logistic analysis, larger tumor size (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.16-1.31; P < 0.001), presence of ulcer (OR, 1.80; 95% CI, 1.15-2.82, P = 0.010), undifferentiated histology (OR, 1.64; 95% CI, 1.25-2.16; P < 0.001), submucosal invasion (OR, 2.28, 95% CI, 1.38-3.76, P = 0.001), middle (OR, 2.12; 95% CI, 1.26-3.55, P = 0.004) or lower third location (OR, 2.28; 95% CI, 1.32-3.60, P = 0.002), and younger age (OR, 0.98; 95% CI, 0.97-0.99; P = 0.002) independently predicted LNM in LVI-positive EGC patients. LVI-positive patients fulfilling the absolute endoscopic resection criteria did not have LNM, and there was no significant difference in the overall (P = 0.928) and disease-specific survival (P = 0.821) between these patients and those with LVI-negative EGC. Conclusions: Additional surgery after endoscopic resection might be unnecessary in LVI-positive patients meeting the absolute criteria for endoscopic resection.

Download Full-text

Risk factors of residual or recurrent tumor in patients with a tumor-positive resection margin after endoscopic resection of early gastric cancer

Surgical Endoscopy ◽

10.1007/s00464-012-2627-3 ◽

2012 ◽

Vol 27 (5) ◽

pp. 1561-1568 ◽

Cited By ~ 38

Author(s):

Hyuk Yoon ◽

Sang Gyun Kim ◽

Jeongmin Choi ◽

Jong Pil Im ◽

Joo Sung Kim ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Early Gastric Cancer ◽

Endoscopic Resection ◽

Resection Margin ◽

Recurrent Tumor ◽

Positive Resection Margin

Download Full-text

A nomogram to predict risk of lymph node metastasis in early gastric cancer

Scientific Reports ◽

10.1038/s41598-021-02305-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Miaoquan Zhang ◽

Chao Ding ◽

Lin Xu ◽

Shoucheng Feng ◽

Yudong Ling ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Early Gastric Cancer ◽

Predictive Accuracy ◽

Histological Grade ◽

Characteristic Curve ◽

Chi Square ◽

Discriminative Ability ◽

Independent Risk Factors

AbstractLymph node (LN) metastasis is known as one of the most important prognostic factors for early gastric cancer (EGC) patients. Patients without LNM normally have better prognosis. However, there is no evaluation criteria to accurately assess the possibility of LN metastasis. Therefore, this study aims to establish an effective nomogram for prognosis prediction. In this study, 285 EGC patients from January 2010 to December 2015 were enrolled. Pearson’s Chi-Square (χ2) test (including continuity correction when appropriate) and logistics regression analyses was used to identify the risk factors for LN metastasis. The independent risk factors identified were then incorporated in a nomogram model. The predictive accuracy and discriminative ability of the nomogram were evaluated by receiver operating characteristic curve (ROC) and calibration curve. LN metastasis occurred in 59 (20.7%) EGC patients. And most of these patients were submucosal cancers (48/59). Chi-square test indicated lymphovascular emboli, carbohydrate antigen 19-9 (CA19-9), ulcer, tumor size, tumor infiltration and histological grade were the risk factors, and multivariate logistics analyses confirmed all these six factors were independent risk factors of LN metastasis, which were selected to construct the nomogram. The nomogram proved well calibrated and had good discriminative ability (C-index value: 0.842). The proposed nomogram could result in more-accurate risk prediction for EGC patients.

Download Full-text