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- Title
Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis.
- Authors
Satoru Kikuchi; Shinji Kuroda; Masahiko Nishizaki; Tetsuya Kagawa; Hiromitsu Kanzaki; Yoshiro Kawahara; Shunsuke Kagawa; Takehiro Tanaka; Hiroyuki Okada; Toshiyoshi Fujiwara; Kikuchi, Satoru; Kuroda, Shinji; Nishizaki, Masahiko; Kagawa, Tetsuya; Kanzaki, Hiromitsu; Kawahara, Yoshiro; Kagawa, Shunsuke; Tanaka, Takehiro; Okada, Hiroyuki; Fujiwara, Toshiyoshi
- Abstract
<bold>Background: </bold>Endoscopic resection (ER) has been widely accepted as the standard treatment for early gastric cancer (EGC). However, in patients considered to have undergone non-curative ER due to their potential risk of lymph node metastasis (LNM), additional gastrectomy is recommended. The aim of the present study was to identify EGC patients after non-curative ER at high risk of LNM.<bold>Methods: </bold>A total of 150 patients who had undergone ER for EGC were diagnosed as non-curative ER due to their potential risk of LNM. Clinicopathological data and clinical outcomes were examined retrospectively.<bold>Results: </bold>Additional gastrectomy with lymph node dissection was performed in 73 patients, and the remaining 77 patients were followed-up without additional gastrectomy. In patients who underwent additional gastrectomy, 8 patients had local residual tumor, and 8 patients had LNM, which were limited in the peritumoral nodes. Only lymphatic invasion (p = 0.012) was a statistically significant factor for LNM. The 5-year overall survival and recurrence-free survival were not significantly different between patients with and without additional gastrectomy.<bold>Conclusion: </bold>Additional gastrectomy with lymph node dissection is recommended for patients who were diagnosed as non-curative ER with lymphatic invasion, and minimizing the extent of lymph node dissection may be allowed for these patients.
- Subjects
STOMACH cancer treatment; LYMPHADENECTOMY; ENDOSCOPY; COHORT analysis; GASTRECTOMY; SURGICAL excision; LONGITUDINAL method; LYMPH node surgery; METASTASIS; STOMACH tumors; RETROSPECTIVE studies; EARLY detection of cancer
- Publication
BMC Surgery, 2017, Vol 17, p1
- ISSN
1471-2482
- Publication type
journal article
- DOI
10.1186/s12893-017-0268-0