Differences in Prevalence of Lymphovascular Invasion among Early Gastric Cancers between Korea and Japan

Abstract

Background/AimsThe presence of invasion is a diagnostic criterion of early gastric cancer (EGC) in Korea, whereas diagnosis in Japan is based on enlarged nuclei and prominent nucleoli. Moreover, the depth of invasion is the location of cancer cell infiltration in Korea, whereas it is the location of lymphovascular invasion (LVI) or cancer cell infiltration in Japan. We evaluated the characteristics of EGC with LVI to uncover the effects of different diagnostic criteria.MethodsConsecutive T1-stage EGC patients who underwent complete resection were included after endoscopic or surgical resection. The presence of LVI was evaluated.ResultsLVI was present in 112 of 1,089 T1-stage EGC patients. LVI was associated with depth of invasion (p<0.001) and age (p=0.017). The prevalence of LVI in mucosal cancer was significantly higher in Korea (p<0.001), whereas that of submucosal cancer was higher in Japan (p=0.024). For mucosal EGC types, LVI was positively correlated with diagnostic criteria applied in Korea (p=0.017). For submucosal EGC types, LVI was positively correlated with Japanese criteria (p=0.001) and old age (p=0.045).ConclusionsThe higher prevalence of LVI for mucosal EGC in Korea and for submucosal EGC in Japan indicates that different diagnostic criteria should be considered when reading publications from other countries.

The Effectiveness of Postoperative Chemotherapy on pT1bN0 and pT2N0 Gastric Cancer Patients with Risk Factors: An International Dual-Center Analysis

“… 1 2 Due to the improvement in people's health awareness, as well as the popularization of gastroscopy and the implementation of cancer screening program, the proportion of gastric cancer detected at early stage (T1bN0M0 and T2N0M0) is increasing, especially in Korea and Japan. 3 …”

“…1,2 Due to the improvement in people's health awareness, as well as the popularization of gastroscopy and the implementation of cancer screening program, the proportion of gastric cancer detected at early stage (T1bN0M0 and T2N0M0) is increasing, especially in Korea and Japan. 3 According to the National Comprehensive Cancer Network Guidelines (version 1. 2019, Gastric Cancer), postoperative chemotherapy is recommended for patients who have T2 or higher, or N+ gastric cancer.…”

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“…Differences in the diagnostic criteria for HPNGC in Japan and other countries may hinder the understanding of this disease. 24 The only way for endoscopists to expand their understanding of HPNGC is to actively collect information by attending scientific meetings and educational lectures, or by searching the literature; therefore, disease awareness is an urgent issue. Furthermore, real-world data on the endoscopists’ actual understanding of HPNGC in Japan and the number of cases diagnosed annually are lacking.…”