TY - JOUR
T1 - The Role of an Undifferentiated Component in Submucosal Invasion and Submucosal Invasion Depth after Endoscopic Submucosal Dissection for Early Gastric Cancer
AU - Miyahara, Koji
AU - Hatta, Waku
AU - Nakagawa, Masahiro
AU - Oyama, Tsuneo
AU - Kawata, Noboru
AU - Takahashi, Akiko
AU - Yoshifuku, Yoshikazu
AU - Hoteya, Shu
AU - Hirano, Masaaki
AU - Esaki, Mitsuru
AU - Matsuda, Mitsuru
AU - Ohnita, Ken
AU - Shimoda, Ryo
AU - Yoshida, Motoyuki
AU - Dohi, Osamu
AU - Takada, Jun
AU - Tanaka, Keiko
AU - Yamada, Shinya
AU - Tsuji, Tsuyotoshi
AU - Ito, Hirotaka
AU - Aoyagi, Hiroyuki
AU - Shimosegawa, Tooru
N1 - Funding Information:
We thank Hiroyuki Ono (Shizuoka Cancer Center), Koki Nakamura (Hiroshima City Hospital), Naohiko Harada (National Hospital Organization Kyushu Medical Center), Yasumasa Hara (Toyama Prefectural Central Hospital), and Kohei Yamanouchi (Saga Medical School) for the enrollment of patients and data collection.
Publisher Copyright:
© 2018 S. Karger AG, Basel. Copyright: All rights reserved.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background/Aims: The role of an undifferentiated component in submucosal invasion and submucosal invasion depth (SID) for lymph node metastasis (LNM) of early gastric cancer (EGC) with deep submucosal invasion (SID ≥500 μm from the muscularis mucosa) after endoscopic submucosal dissection (ESD) has not been fully understood. This study aimed to clarify the risk factors (RFs), including these factors, for LNM in such patients. Methods: We enrolled 513 patients who underwent radical surgery after ESD for EGC with deep submucosal invasion. We evaluated RFs for LNM, including an undifferentiated component in submucosal invasion and the SID, which was subdivided into 500-999, 1,000-1,499, 1,500-1,999, and ≥2,000 μm. Results: LNM was detected in 7.6% of patients. Multivariate analysis revealed that an undifferentiated component in submucosal invasion (OR 2.22), in addition to tumor size >30 mm (OR 2.51) and lymphatic invasion (OR 3.07), were the independent RFs for LNM. However, the SID was not significantly associated with LNM. Conclusion: An undifferentiated component in submucosal invasion was one of the RFs for LNM, in contrast to SID, in patients who underwent ESD for EGC with deep submucosal invasion. This insight would be helpful in managing such patients.
AB - Background/Aims: The role of an undifferentiated component in submucosal invasion and submucosal invasion depth (SID) for lymph node metastasis (LNM) of early gastric cancer (EGC) with deep submucosal invasion (SID ≥500 μm from the muscularis mucosa) after endoscopic submucosal dissection (ESD) has not been fully understood. This study aimed to clarify the risk factors (RFs), including these factors, for LNM in such patients. Methods: We enrolled 513 patients who underwent radical surgery after ESD for EGC with deep submucosal invasion. We evaluated RFs for LNM, including an undifferentiated component in submucosal invasion and the SID, which was subdivided into 500-999, 1,000-1,499, 1,500-1,999, and ≥2,000 μm. Results: LNM was detected in 7.6% of patients. Multivariate analysis revealed that an undifferentiated component in submucosal invasion (OR 2.22), in addition to tumor size >30 mm (OR 2.51) and lymphatic invasion (OR 3.07), were the independent RFs for LNM. However, the SID was not significantly associated with LNM. Conclusion: An undifferentiated component in submucosal invasion was one of the RFs for LNM, in contrast to SID, in patients who underwent ESD for EGC with deep submucosal invasion. This insight would be helpful in managing such patients.
KW - Early gastric cancer
KW - Endoscopic submucosal dissection
KW - Lymph node metastasis
KW - Submucosal invasion depth
KW - Undifferentiated component in submucosal invasion
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UR - http://www.scopus.com/inward/citedby.url?scp=85048161673&partnerID=8YFLogxK
U2 - 10.1159/000488529
DO - 10.1159/000488529
M3 - Article
C2 - 29870985
AN - SCOPUS:85048161673
SN - 0012-2823
VL - 98
SP - 161
EP - 168
JO - Digestion
JF - Digestion
IS - 3
ER -
