Hiroki Osumi1, Hiroshi Kawachi2, Toshiyuki Yoshio3, Satoshi Ida4, Noriko Yamamoto2, Yusuke Horiuchi1, Akiyoshi Ishiyama1, Toshiaki Hirasawa1, Tomohiro Tsuchida1, Naoki Hiki4, Kengo Takeuchi2, Junko Fujisaki1. 1. Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. 2. Department of Pathology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. 3. Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. toshiyuki.yoshio@jfcr.or.jp. 4. Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Abstract
BACKGROUND: Epstein-Barr virus-positive gastric cancer (EBVGC) is associated with a low prevalence of lymph node metastasis (LNM); however, EBV status is not considered in the indication of endoscopic resection (ER). We aimed to clarify the implication of EBV status for ER of pT1b GC. METHODS: Consecutive cases of pT1b GCs treated with surgery between 2005 and 2014 were retrospectively analyzed. Clinicopathological factors and LNM status were compared between EBVGC and non-EBVGC groups. RESULTS: EBVGC accounted for 7.9% (71 of 898) cases. Compared to non-EBVGC, EBVGC was more frequent in males (p = 0.0055), the upper third region (p < 0.0001), showed elevated growth features (p = 0.0059), and was associated with a lower frequency of accompanying ulceration (p = 0.002), greater depth of submucosal invasion (p = 0.017), and lower frequency of lymphatic invasion (p < 0.0001). Frequency of LNM was significantly lower in EBVGC than in non-EBVGC (4.2% vs. 21.9%, p < 0.0001). In EBVGC, tumors without lymphovascular invasion showed significantly lower frequency of LNM than those with lymphovascular invasion (0 of 50, 0%; vs 3 of 21, 14.3%; p = 0.023). Histologically, 84.5% (60 of 71) of EBVGC included carcinomas with lymphoid stroma and/or lace pattern components. CONCLUSIONS: pT1b EBVGC is a convincing candidate for ER, regardless of risk factors other than lymphovascular invasion.
BACKGROUND:Epstein-Barr virus-positive gastric cancer (EBVGC) is associated with a low prevalence of lymph node metastasis (LNM); however, EBV status is not considered in the indication of endoscopic resection (ER). We aimed to clarify the implication of EBV status for ER of pT1b GC. METHODS: Consecutive cases of pT1b GCs treated with surgery between 2005 and 2014 were retrospectively analyzed. Clinicopathological factors and LNM status were compared between EBVGC and non-EBVGC groups. RESULTS: EBVGC accounted for 7.9% (71 of 898) cases. Compared to non-EBVGC, EBVGC was more frequent in males (p = 0.0055), the upper third region (p < 0.0001), showed elevated growth features (p = 0.0059), and was associated with a lower frequency of accompanying ulceration (p = 0.002), greater depth of submucosal invasion (p = 0.017), and lower frequency of lymphatic invasion (p < 0.0001). Frequency of LNM was significantly lower in EBVGC than in non-EBVGC (4.2% vs. 21.9%, p < 0.0001). In EBVGC, tumors without lymphovascular invasion showed significantly lower frequency of LNM than those with lymphovascular invasion (0 of 50, 0%; vs 3 of 21, 14.3%; p = 0.023). Histologically, 84.5% (60 of 71) of EBVGC included carcinomas with lymphoid stroma and/or lace pattern components. CONCLUSIONS: pT1b EBVGC is a convincing candidate for ER, regardless of risk factors other than lymphovascular invasion.
Authors: Josine van Beek; Axel zur Hausen; Elma Klein Kranenbarg; Cornelis J H van de Velde; Jaap M Middeldorp; Adriaan J C van den Brule; Chris J L M Meijer; Elisabeth Bloemena Journal: J Clin Oncol Date: 2004-02-15 Impact factor: 44.544