Abstract:
AIM:To explore risk factors for lymph node metastases in early gastric cancer (EGC) and to confirm the appropriate range of lymph node dissection. METHODS:A total of 202 patients with EGC who underwent curative gastrectomy with lymphadenectomy in the Department of Surgery, Xinhua Hospital and Ruijin Hospital of Shanghai Jiaotong University Medical School between November 2003 and July 2009, were retrospectively reviewed. Both the surgical procedure and the extent of lymph node dissection were based on the recommendations of the Japanese gastric cancer treatment guidelines. The macroscopic type was classified as elevated (type I or IIa), flat (IIb), or depressed (IIc or III). Histopathologically, papillary and tubular adenocarcinomas were grouped together as differentiated adenocarcinomas, and poorly differentiated and signet-ring cell adenocarcinomas were regarded as undifferentiated adenocarcinomas. Univariate and multivariate analyses of lymph node metastases and patient and tumor characteristics were undertaken. RESULTS:The lymph node metastases rate in patients with EGC was 14.4%. Among these, the rate for mucosal cancer was 5.4%, and 8.9% for submucosal cancer. Univariate analysis showed an obvious correlation between lymph node metastases and tumor location, depth of invasion, morphological classification and venous invasion (χ(2) = 122.901, P = 0.001; χ(2) = 7.14, P = 0.008; χ(2) = 79.523, P = 0.001; χ(2) = 8.687, P = 0.003, respectively). In patients with submucosal cancers, the lymph node metastases rate in patients with venous invasion (60%, 3/5) was higher than in those without invasion (20%, 15/75) (χ(2) = 4.301, P = 0.038). Multivariate logistic regression analysis revealed that the depth of invasion was the only independent risk factor for lymph node metastases in EGC [P = 0.018, Exp (B) = 2.744]. Among the patients with lymph node metastases, 29 cases (14.4%) were at N1, seven cases were at N2 (3.5%), and two cases were at N3 (1.0%). Univariate analysis of variance revealed a close relationship between the depth of invasion and lymph node metastases at pN1 (P = 0.008). CONCLUSION:The depth of invasion was the only independent risk factor for lymph node metastases. Risk factors for metastases should be considered when choosing surgery for EGC.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Ren G,Cai R,Zhang WJ,Ou JM,Jin YN,Li WHdoi
10.3748/wjg.v19.i20.3096subject
Has Abstractpub_date
2013-05-28 00:00:00pages
3096-107issue
20eissn
1007-9327issn
2219-2840journal_volume
19pub_type
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
pub_type: 评论,杂志文章
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2006-10-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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更新日期:2009-01-14 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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更新日期:2008-08-28 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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更新日期:2015-01-07 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v11.i46.7290
更新日期:2005-12-14 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2009-02-21 00:00:00