BACKGROUND: Although endoscopic resection for early gastric cancer (EGC) is increasingly available, it has not been determined whether indications for endoscopic resection are equally acceptable for multiple EGCs. OBJECTIVE: To compare the various clinicopathologic factors and risk of lymph node (LN) metastasis between multiple and solitary EGCs. DESIGN: Case-control study. SETTING: University hospital. PATIENTS: This study involved 1717 patients with 156 multiple and 1561 solitary EGCs. INTERVENTION: Gastrectomy with LN dissection. MAIN OUTCOME MEASUREMENTS: Incidence of LN metastasis. RESULTS: In multiple EGCs, main lesions had larger tumor size and deeper invasion depth than the accessory lesions (P < .001). The clinicopathologic features of multiple EGCs were similar to those of solitary EGCs with respect to tumor size, depth of invasion, lymphovascular invasion, and incidence of LN metastasis. Importantly, the risk of LN metastasis in multiple EGCs that met the indication criteria for endoscopic resection was not significantly different from that in solitary EGCs. Tumors meeting conventional indications for endoscopic resection had no risk of LN metastasis, whereas tumors meeting expanded indications showed a similar risk of LN metastasis in the two groups. In multiple EGCs, tumor size ≥3 cm and lymphovascular invasion were independent risk factors of LN metastasis. LIMITATIONS: Small number of patients with multiple EGCs studied. CONCLUSION: Multiple EGCs had clinicopathologic characteristics and risk of LN metastasis similar to those of solitary EGCs. Endoscopic resection may be adopted as curative treatment for multiple EGCs that meet indications for endoscopic resection. Further studies are needed to verify the present study results.
BACKGROUND: Although endoscopic resection for early gastric cancer (EGC) is increasingly available, it has not been determined whether indications for endoscopic resection are equally acceptable for multiple EGCs. OBJECTIVE: To compare the various clinicopathologic factors and risk of lymph node (LN) metastasis between multiple and solitary EGCs. DESIGN: Case-control study. SETTING: University hospital. PATIENTS: This study involved 1717 patients with 156 multiple and 1561 solitary EGCs. INTERVENTION: Gastrectomy with LN dissection. MAIN OUTCOME MEASUREMENTS: Incidence of LN metastasis. RESULTS: In multiple EGCs, main lesions had larger tumor size and deeper invasion depth than the accessory lesions (P < .001). The clinicopathologic features of multiple EGCs were similar to those of solitary EGCs with respect to tumor size, depth of invasion, lymphovascular invasion, and incidence of LN metastasis. Importantly, the risk of LN metastasis in multiple EGCs that met the indication criteria for endoscopic resection was not significantly different from that in solitary EGCs. Tumors meeting conventional indications for endoscopic resection had no risk of LN metastasis, whereas tumors meeting expanded indications showed a similar risk of LN metastasis in the two groups. In multiple EGCs, tumor size ≥3 cm and lymphovascular invasion were independent risk factors of LN metastasis. LIMITATIONS: Small number of patients with multiple EGCs studied. CONCLUSION: Multiple EGCs had clinicopathologic characteristics and risk of LN metastasis similar to those of solitary EGCs. Endoscopic resection may be adopted as curative treatment for multiple EGCs that meet indications for endoscopic resection. Further studies are needed to verify the present study results.
Authors: Linda Bardram; Thomas V O Hansen; Anne-Marie Gerdes; Susanne Timshel; Lennart Friis-Hansen; Birgitte Federspiel Journal: Fam Cancer Date: 2014-06 Impact factor: 2.375
Authors: Ji Young Choi; Young Soo Park; Hwoon-Yong Jung; Da Hye Son; Ji Yong Ahn; Seungbong Han; Hyun Lim; Kwi-Sook Choi; Jeong Hoon Lee; Do Hoon Kim; Kee Don Choi; Ho June Song; Gin Hyug Lee; Jin-Ho Kim Journal: Surg Endosc Date: 2014-09-24 Impact factor: 4.584
Authors: Rachel S van der Post; Ingrid P Vogelaar; Fátima Carneiro; Parry Guilford; David Huntsman; Nicoline Hoogerbrugge; Carlos Caldas; Karen E Chelcun Schreiber; Richard H Hardwick; Margreet G E M Ausems; Linda Bardram; Patrick R Benusiglio; Tanya M Bisseling; Vanessa Blair; Eveline Bleiker; Alex Boussioutas; Annemieke Cats; Daniel Coit; Lynn DeGregorio; Joana Figueiredo; James M Ford; Esther Heijkoop; Rosella Hermens; Bostjan Humar; Pardeep Kaurah; Gisella Keller; Jennifer Lai; Marjolijn J L Ligtenberg; Maria O'Donovan; Carla Oliveira; Hugo Pinheiro; Krish Ragunath; Esther Rasenberg; Susan Richardson; Franco Roviello; Hans Schackert; Raquel Seruca; Amy Taylor; Anouk Ter Huurne; Marc Tischkowitz; Sheena Tjon A Joe; Benjamin van Dijck; Nicole C T van Grieken; Richard van Hillegersberg; Johanna W van Sandick; Rianne Vehof; J Han van Krieken; Rebecca C Fitzgerald Journal: J Med Genet Date: 2015-05-15 Impact factor: 6.318