scholarly journals Clinicopathological and prognostic features of early gastric cancer patients after surgery: a retrospective study

2020 ◽  
Author(s):  
Jing Qi ◽  
Congbo Zhu ◽  
Weihang Liu ◽  
Sheng Liu ◽  
Gaoqiang Cai ◽  
...  

Abstract Background: Despite the decline in the incidence of gastric cancer, the incidence of early gastric cancer has increased. Hence, understanding the clinicopathological and prognostic features of early gastric cancers could help us understand the development of gastric cancer and improve the prognosis of early gastric cancer. Methods: A total of 244 patients diagnosed with early gastric cancer after surgery at Xiangya Hospital Central South University were retrospectively analyzed. Results: General data showed that in patients with a mean age of 54.30±10.68 years (M:F = 1.6:1), the median tumor size was 2.203±1.245 cm. A total of 15.6% of patients had lymph node metastasis. By univariate analysis, the longest diameter of the tumor, T stage, total number of dissected lymph nodes, number of metastatic lymph nodes, metastatic-to-total dissected lymph node (LN) ratio, vascular invasion, NLRc, and MLRc were associated with disease-free survival; tumor size, invasive depths, vascular invasion, NLRc, MLRc, NWRc and LWRc were associated with lymph node metastasis. Additionally, the longest diameter of tumor and total number of dissected lymph nodes were independent factors for early gastric cancer patients; tumor size, invasive depths, vascular invasion and NLRc were independent risk factors for lymph node metastasis in EGC. Conclusion: The longest diameter of the tumor and total number of dissected LNs were independent prognostic factors for EGC patients. Additionally, the longest diameter of the tumor, tumor invasive depths, vascular invasion and NLRc were the independent risk factors for lymph node metastasis in EGC patients.

2020 ◽  
Author(s):  
Jun Du ◽  
Yangchao Shen ◽  
Wenwu Yan ◽  
Jinguo Wang

Abstract Background It remains controversial whether splenic hilum lymph nodes (SHLNs) should be excised in radical gastrectomy with D2 lymph node dissection. In this study, we evaluated the role of clinicopathological features in patients with gastric cancer in predicting splenic hilum lymph nodes metastasis.Methods We searched the Medline, Embase, PubMed and Web of Science databases from inception to May 2020 and consulted related references. 15 articles with a total of 4377 patients were included finally. The odds ratios (ORs) of each risk factor and the corresponding 95% confidence interval (CI) were determined using Revman 5.3 software. Results Meta-analysis showed that tumor size greater than 5 cm (p < 0.01), tumor localization in the greater curvature (p < 0.01), diffuse type (Lauren’s type) (p < 0.01), Borrman type 3–4 (p < 0.01), poor differentiation and undifferentiation (p < 0.01), depth of invasion T3–T4 (p < 0.01), number of lymph node metastases N2–N3 (p < 0.01), distance metastasis M1 (p < 0.01), TNM stage 3–4 (p < 0.01), vascular invasion (p = 0.01), and lymphatic invasion (p < 0.01) were risk factors of SHLNs metastasis. Moreover, No. 1-, 2-, 3-, 4sa-, 4sb-, 4d-, 6-, 7-, 9-, 11-, and 16-positive lymph node metastasis are strongly associated with splenic hilum lymph nodes metastasis.Conclusions Tumor size, tumor location, Lauren’s type, Borrman type, degree of differentiation, T stage, N stage, M stage, TNM stage, vascular invasion, lymphatic infiltration, and other positive lymph nodes metastasis were risk factors for SHLNs.


2020 ◽  
Vol 13 ◽  
pp. 175628482093503
Author(s):  
Bolun Jiang ◽  
Li Zhou ◽  
Jun Lu ◽  
Yizhi Wang ◽  
Junchao Guo

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.


2019 ◽  
Vol 15 (31) ◽  
pp. 3609-3617 ◽  
Author(s):  
Jianfeng Mu ◽  
Zhifang Jia ◽  
Weikai Yao ◽  
Jiaxing Song ◽  
Xueyuan Cao ◽  
...  

Aim: To develop and validate a model to predict possibility of lymph node metastasis (LNM) in early gastric cancer. Materials & methods: An LNM prediction model was developed by logistic regression based on the demographics or characteristics of the tumor (N = 746) and then internally and externally validated (N = 126). Results: Four variables, lymphovascular invasion, differentiated types, diameter of tumor and T stage were screened into the model. The area under the receiver-operating characteristic curve of the model was 0.861 (95% CI: 0.851–0.864) in internal validation and 0.911 (95% CI: 0.848–0.974) in the validation set. Conclusion: The model shows excellent discrimination and calibration performance, and is potential to be a useful clinical model to predict the risk of LNM in early gastric cancer.


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Xiao-Yi Yin ◽  
Tao Pang ◽  
Yu Liu ◽  
Hang-Tian Cui ◽  
Tian-Hang Luo ◽  
...  

Abstract Background The status of lymph nodes in early gastric cancer is critical to make further clinical treatment decision, but the prediction of lymph node metastasis remains difficult before operation. This study aimed to develop a nomogram that contained preoperative factors to predict lymph node metastasis in early gastric cancer patients. Methods This study analyzed the clinicopathologic features of 823 early gastric cancer patients who underwent gastrectomy retrospectively, among which 596 patients were recruited in the training cohort and 227 patients in the independent validation cohort. Significant risk factors in univariate analysis were further identified to be independent variables in multivariable logistic regression analysis, which were then incorporated in and presented with a nomogram. And internal and external validation curves were plotted to evaluate the discrimination of the nomogram. Results Totally, six independent predictors, including the tumor size, macroscopic features, histology differentiation, P53, carbohydrate antigen 19-9, and computed tomography-reported lymph node status, were enrolled in the nomogram. Both the internal validation in the training cohort and the external validation in the validation cohort showed the nomogram had good discriminations, with a C-index of 0.82 (95%CI, 0.78 to 0.86) and 0.77 (95%CI, 0.60 to 0.94) respectively. Conclusions Our study developed a new nomogram which contained the most common and significant preoperative risk factors for lymph node metastasis in patients with early gastric cancer. The nomogram can identify early gastric cancer patients with the high probability of lymph node metastasis and help clinicians make more appropriate decisions in clinical practice.


2019 ◽  
Vol 156 (6) ◽  
pp. S-1025
Author(s):  
Min Young Son ◽  
Sung Eun Kim ◽  
Moo In Park ◽  
Seun Ja Park ◽  
Won Moon ◽  
...  

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