Predictive Factors for Lymph Node Metastasis in Early Gastric Cancer With Submucosal Invasion

An, Ji Yeong; Baik, Yong Hae; Choi, Min Gew; Noh, Jae Hyung; Sohn, Tae Sung; Kim, Sung

doi:10.1097/sla.0b013e31811f3fb7

Cited by 165 publications

(115 citation statements)

References 16 publications

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“…An et al (2007) reported that no lymph node metastasis was observed in the cases with no lymphatic involvement, SM1 invasion, and tumor size <1cm. The study in a large group of Japanese patients found that in cases where the histology is a differentiated type and without vascular invasion, the rate of lymph node metastasis in submucosal invasion less than 500μm was only 0.9% (Ishikawa et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…Yamao et al ( Yamao et al, 1996) reported that lymphatic invasion, histological ulceration of tumors and larger tumor sizes are independent risk factors for lymph node metastases in intramucosal early gastric cancer. An et al (2007) reported that tumor size and lymphatic involvement were independent risk factors for lymph node metastasis in early gastric cancer with submucosal invasion. Shen et al (2009) reported that histological classification, macroscopic type, tumor size, depth of gastric carcinoma infiltration, and the presence of vascular or lymphatic invasion were significantly and independently related to lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk of Lymph Node Metastases from Early Gastric Cancer in Relation to Depth of Invasion: Experience in a Single Institution

Wang¹,

Ma²,

Zhang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: An accurate assessment of potential lymph node metastasis is important for the appropriate treatment of early gastric cancers. Therefore, this study analyzed predictive factors associated with lymph node metastasis and identified differences between mucosal and submucosal gastric cancers. Materials and Methods: A total of 518 early gastric cancer patients who underwent radical gastrectomy were reviewed in this study. Clinicopathological features were analyzed to identify predictive factors for lymph node metastasis. Results: The rate of lymph node metastasis in early gastric cancer was 15.3% overall, 3.3% for mucosal cancer, and 23.5% for submucosal cancer. Using univariate analysis, risk factors for lymph node metastasis were identified as tumor location, tumor size, depth of tumor invasion, histological type and lymphovascular invasion. Multivariate analysis revealed that tumor size >2 cm, submucosal invasion, undifferentiated tumors and lymphovascular invasion were independent risk factors for lymph node metastasis. When the carcinomas were confined to the mucosal layer, tumor size showed a significant correlation with lymph node metastasis. On the other hand, histological type and lymphovascular invasion were associated with lymph node metastasis in submucosal carcinomas. Conclusions: Tumor size >2 cm, submucosal tumor, undifferentiated tumor and lymphovascular invasion are predictive factors for lymph node metastasis in early gastric cancer. Risk factors are quite different depending on depth of tumor invasion. Endoscopic treatment might be possible in highly selective cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk of Lymph Node Metastases from Early Gastric Cancer in Relation to Depth of Invasion: Experience in a Single Institution

Wang¹,

Ma²,

Zhang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…It is still impossible, however, to accurately detect cancer-positive lymph nodes by imaging techniques such as endoscopic ultrasound (EUS) or computed tomography (CT) [15,16]. For this reason, multiple patient-and tumor-related variables are investigated as predictors of lymph node involvement, especially in EGC with invasion of the submucosa [17].…”

mentioning

confidence: 99%

Predicting lymph node metastases in early gastric cancer: radical resection or organ-sparing therapy?

Novotny

Schuhmacher

2008

Gastric Cancer

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“…However, there are cases in which lymph node metastasis is not associated with ly and vice versa. The correlation between ly and lymph node metastasis has been shown in gastric (11) and colorectal cancer (12). This correlation is a general relationship irrespective of the depth of invasion (3).…”

Section: Discussionmentioning

confidence: 98%

Surgical treatments for squamous cell carcinoma of the esophagus reaching to the muscularis mucosa or the upper third of the submucosal layer

Ozawa¹,

Saikawa²,

Kitagawa³

2010

Oncology Letters

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Abstract.We studied the surgical treatments of patients with either esophageal cancer reaching to the muscularis mucosae (m3) or with a slight invasion of the submucosa (sm1). We reviewed the records and examined the clinicopathological features of 29 patients with m3 or sm1 esophageal squamous cell carcinoma who had undergone surgery. Lymph node metastasis was noted in 6.3% (1 patient) of patients with m3 cancers and in 38.5% (5 patients) of those with sm1 cancers. The incidence of lymph node metastasis was higher in the sm1 than in the m3 group, but the difference was not significant. Lymphatic invasion (ly) was noted in 12.3% (2 patients) of patients with m3 cancers and in 53.8% (7 patients) of those with sm1 cancers. The incidence of ly was significantly higher in the sm1 group than in the m3 group (P<0.05). In a multivariate analysis of factors for predicting lymph node metastasis, the presence of ly was the only significant predictor (P<0.05). The preoperative diagnostic accuracies of endoscopic ultrasonography (EUS), esophagogastroduodenoscopy (EGD) and an upper gastrointestinal series (UGS) for predicting depth of invasion were 27.8, 31.0 and 41.4%, respectively, with the majority of the misdiagnoses being overestimations. In conclusion, we suggested that ly is associated with lymph node metastasis in m3 or sm1 esophageal cancer. This association is significant for treatment-related decision making. IntroductionRecent diagnostic developments have led to the detection of superficial esophageal cancer. Consequently, an increase in the number of candidates for endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) has been noted. Esophageal cancers extending to the intraepithelium (m1) or lamina propria (m2), in particular, rarely have lymph node metastasis or lymphatic invasion (ly) and are thus curative by local treatment and suitable for treatment with EMR/ ESD (1,2). On the other hand, the frequency of lymph node metastasis from cancer of the muscularis mucosa (m3) or the upper third of the submucosal layer (sm1) is 18.0 and 53.1%, respectively (3). In certain cases local treatment alone would be adequate; however, in other cases treatment for lymph node metastasis would need to be considered. Treatment strategies for m3 and sm1 cancers remain controversial. To provide appropriate treatment for these types of cancer, it would be useful to be able to identify patients that need treatment for lymph node metastasis. Diagnosis of lymph node metastasis from esophageal cancer by computed tomography (CT), ultrasonography and FDG-PET currently lacks accuracy. Subsequently, the accurate diagnosis of esophageal cancer prior to treatment presents a challenge. Depth of superficial esophageal cancer is normally diagnosed using endoscopy, endoscopic ultrasonography and a gastrointestinal series. However, despite the availability of these current modalities, accurate diagnosis of tumor depth remains difficult. If a clear diagnosis prior to treatment for m3 and sm1 esophageal cancer and accurate ...

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Predictive Factors for Lymph Node Metastasis in Early Gastric Cancer With Submucosal Invasion

Cited by 165 publications

References 16 publications

Risk of Lymph Node Metastases from Early Gastric Cancer in Relation to Depth of Invasion: Experience in a Single Institution

Risk of Lymph Node Metastases from Early Gastric Cancer in Relation to Depth of Invasion: Experience in a Single Institution

Predicting lymph node metastases in early gastric cancer: radical resection or organ-sparing therapy?

Surgical treatments for squamous cell carcinoma of the esophagus reaching to the muscularis mucosa or the upper third of the submucosal layer

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