Clinicopathologic characteristics of patients who underwent additional gastrectomy after incomplete endoscopic resection for early gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 39-39 ◽  
Author(s):  
Jae Jin Hwang ◽  
Dong Ho Lee ◽  
Ae-Ra Lee ◽  
Hyuk Yoon ◽  
Cheol Min Shin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Residual Tumor ◽  
Incomplete Resection ◽  
Histologic Diagnosis ◽  
Factors Associated ◽  
Node Metastasis ◽  
H Pylori ◽  
Additional Gastrectomy

39 Background: Endoscopic resection (ER) is widely accepted as standard treatment for early gastric cancer (EGC) without lymph node metastasis. However, surgery is sometimes needed after endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) due to incomplete resection. We analyzed the clinicopathological characteristics of patients who underwent additional gastrectomy after incomplete EMR/ESD. Methods: From 2003 to 2013, 80 patients received additional gastrectomy after EMR/ESD due to incomplete resection. The patients were grouped according to the presence of histologic residual tumor in specimens obtained by gastrectomy as residual tumor (RT, n = 47) or non-residual tumor (NRT, n = 33). We analyzed reasons for gastrectomy, tumor characteristics of RT and NRT group, risk factors associated with residual tumor, retrospectively from medical records. Results: After the gastrectomy, the positive residual tumor rate and lymph node metastasis rate were 58.7% (47/80) and 7.5% (6/80). RT group showed significantly higher rate of lateral and vertical margin involvement compared to NRT group (59.5 vs. 15.1%).Multivariate analysis demonstrated that endoscopic piecemeal resection, H. pylori infection, depressed or mixed type, large tumor size (> 2cm), histologic diagnosis (signet ring cell carcinoma or mixed carcinoma) were significantly independent predictive factors associated with positive residual tumor of patients who underwent additional gastrectomy after incomplete EMR/ESD (p < 0.05). Conclusions: For complete and curative ER, endoscopists should try to determine the depth of invasion, histologic diagnosis accurately and to eradicate the H. pylori infection before ER. During ER, wide marking and En bloc resection could be considered to avoid the risk of incomplete resection.

Predictive factors for lymph node metastasis in additional gastrectomy after endoscopic resection of cT1aN0 gastric cancer

Surgery Today ◽  
2015 ◽  
Vol 46 (9) ◽  
pp. 1031-1038 ◽  
Author(s):  
Satoru Ishii ◽  
Keishi Yamashita ◽  
Hiroshi Kato ◽  
Nobuyuki Nishizawa ◽  
Hideki Ushiku ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Endoscopic Resection ◽  
Predictive Factors ◽  
Node Metastasis ◽  
Additional Gastrectomy

scholarly journals Pathological factors related to lymph node metastasis of submucosally invasive gastric cancer: criteria for additional gastrectomy after endoscopic resection

2012 ◽  
Vol 16 (4) ◽  
pp. 521-530 ◽  
Author(s):  
Mototsugu Fujii ◽  
Yutaro Egashira ◽  
Hiroshi Akutagawa ◽  
Tsukasa Nishida ◽  
Toshikatsu Nitta ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Endoscopic Resection ◽  
Node Metastasis ◽  
Additional Gastrectomy

Sa1647 Predictors of Lymph Node Metastasis and Residual Tumor in Non-Curative Endoscopic Resection of Early Gastric Cancer

2014 ◽  
Vol 79 (5) ◽  
pp. AB288
Author(s):  
Hyo-Joon Yang ◽  
Sang Gyun Kim ◽  
Joo Hyun Lim ◽  
Jeongmin Choi ◽  
Jong Pil IM ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Endoscopic Resection ◽  
Residual Tumor ◽  
Node Metastasis

scholarly journals Predictors of lymph node metastasis and residual tumor in early gastric cancer patients after noncurative endoscopic resection: a systematic review and meta-analysis

2020 ◽  
Vol 13 ◽  
pp. 175628482093503
Author(s):  
Bolun Jiang ◽  
Li Zhou ◽  
Jun Lu ◽  
Yizhi Wang ◽  
Junchao Guo
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Tumor Size ◽  
Meta Analysis ◽  
Residual Tumor ◽  
Node Metastasis

Background: It is challenging to identify the prevalence of lymph node metastasis (LNM) and residual tumor in patients with early gastric cancer (EGC) who underwent noncurative endoscopic resection (ER). This present meta-analysis was aimed to establish imperative potential predictive factors in order to select the optimal treatment method. Methods: A systematic literature search of PubMed, Embase, and Cochrane Library databases was performed through 1 February 2019 to identify relevant studies, which investigated risk factors for LNM and residual tumor in patients with EGC who underwent noncurative ER. Eligible data were systematically reviewed through a meta-analysis. Results: Overall, 12 studies investigating the risk factor of LNM were included, totaling 3015 patients, 7 of which also involved cancer residues. After the present meta-analysis, six predictors, including tumor size >30 mm, tumor invasion depth (⩾500 μm from the muscularis mucosae), macroscopic appearance, undifferentiated histopathological type, positive vertical margin, and presence of lymphovascular invasion (including lymphatic invasion and vascular invasion) were significantly associated with LNM, whereas tumor size >30 mm, positive horizontal margin, and positive vertical margin were identified as significant predictors for the risk of residual tumor. No evidence of publication bias was observed. Conclusions: Six and three variables were established as significant risk factors for LNM and residual tumor in patients with EGC who underwent noncurative ER, respectively. Patients with EGC who present these risk factors after noncurative ER are strongly suggested to receive additional surgery, while others might be suitable for strict follow-up. This might shed some new light on the selection of follow-up treatment for noncurative ER.

Sa1579 Clinicopathological Predictive Factors Associated With Lymph Node Metastasis in Intramucosal Early Gastric Cancer

2013 ◽  
Vol 77 (5) ◽  
pp. AB256
Author(s):  
Meng-Jiang He ◽  
Mei-Dong Xu ◽  
L.I-Qing Yao ◽  
Zhou Pinghong ◽  
Quan-Lin Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Predictive Factors ◽  
Factors Associated ◽  
Node Metastasis

Impact of external-beam radiation therapy on outcomes among patients with resected gastric cancer: A multi-institutional analysis.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 84-84
Author(s):  
Aslam Ejaz ◽  
Gaya Spolverato ◽  
Yuhree Kim ◽  
Malcolm Hart Squires ◽  
Sharon M. Weber ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Perioperative Therapy ◽  
Curative Intent ◽  
Factors Associated ◽  
Node Metastasis

84 Background: Use of perioperative chemotherapy (CTx) alone versus chemo-radiation therapy (cXRT) in the treatment of resectable gastric cancer remains varied. We sought to define the utilization and effect of CTx alone versus cXRT on patients having undergone curative-intent resection for gastric cancer. Methods: Using the multi-institutional U.S. Gastric Cancer Collaborative database, we identified 505 patients between 2000 and 2012 with gastric cancer who received perioperative therapy in addition to curative-intent resection. The impact of perioperative therapy on survival was analyzed by the use of propensity-score matching of clinicopathologic factors among patients who received CTx alone versus cXRT. Results: Median patient age was 62 years and the majority of patients were male (58%). Surgical resection involved either partial gastrectomy (54%) or total gastrectomy (46%). On pathology, median tumor size was 5.0 cm; most patients had a T3 (37%) or T4 (36%) lesion and lymph node metastasis (74%). Margin status was R0 in most patients (89%). 211 (42%) patients received perioperative CTx alone whereas the remaining 294 (58%) patients received 5-FU based cXRT. Factors associated with receipt of cXRT were younger age (OR 0.98), T3 tumors (OR 1.52), and lymph node metastasis (OR 2.03) (all P < .05). Recurrence occurred in 214 (39%) patients. At a median follow-up of 28 months, median overall survival (OS) was 33.4 months and 5-year survival was 36.7%. Factors associated with worse OS included tumor size (HR 1.1), T-stage (HR 1.5), and lymph node metastasis (HR 1.58) (all P<0.05). In contrast, receipt of cXRT was associated with improved long-term OS (CTx alone: 21 months vs. cXRT 45 months; p<0.001). In the propensity-matched multivariate model that adjusted for tumor size, T-stage, and nodal status, cXRT remained associated with an improved long-term disease-free (HR 0.43) and overall (HR 0.41) survival (both P<0.001). Conclusions: XRT was utilized in 58% of patients undergoing curative-intent resection for gastric cancer. Using propensity-matched analysis, cXRT was an independent factor associated with improved recurrence-free and overall survival.

scholarly journals Surgical Outcomes and Clinicopathological Characteristics of Patients Who Underwent Potentially Noncurative Endoscopic Resection for Gastric Cancer: A Report of a Single-Center Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Hiroaki Ito ◽  
Haruhiro Inoue ◽  
Haruo Ikeda ◽  
Noriko Odaka ◽  
Akira Yoshida ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Endoscopic Resection ◽  
Surgical Outcomes ◽  
Primary Tumor ◽  
Tumor Invasion ◽  
Venous Invasion ◽  
Incomplete Resection ◽  
Node Metastasis

Background. Standard treatment of early gastric cancer (EGC) after endoscopic resection with risk factors of nodal metastases and incomplete resection is controversial. We investigated optimal management for the patients with potentially noncurative EGC after endoscopic resection.Methods. We retrospectively examined clinicopathological data and surgical outcomes of all patients with clinically solitary gastric adenocarcinoma who underwent curative surgery after a single peroral endoscopic resection at the Digestive Disease Center of Showa University Northern Yokohama Hospital between April 2001 and December 2012. Fisher's exact test was used for univariate analysis. For multivariate analysis, stepwise multiple linear regression was used to identify independent predictors related to lymph node metastasis and remnant of primary tumor.Results. A total of 41 patients were studied. Four patients (9.8%) had lymph node metastases. Primary tumors remained in 6 patients (14.6%). Only venous invasion was statistically significant to lymph node metastasis (P=0.017). With respect to remnant of the primary tumor, pT1b2 tumor invasion (P=0.015) and horizontal margin (P=0.013) were statistically significant.Conclusions. Surgery with limited lymphadenectomy is recommended for tumors with venous invasion or pT1b2 tumor invasion, and additional endoscopic resection may be allowed for tumors with horizontal involvement.

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