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Risk factors of lymph node metastasis after non-curative endoscopic resection of undifferentiated-type early gastric cancer

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dc.contributor.authorYang, Hyo-Joon-
dc.contributor.authorJang, Jae-Young-
dc.contributor.authorKim, Sang Gyun-
dc.contributor.authorAhn, Ji Yong-
dc.contributor.authorNam, Su Youn-
dc.contributor.authorKim, Jie-Hyun-
dc.contributor.authorMin, Byung-Hoon-
dc.contributor.authorLee, Wan-Sik-
dc.contributor.authorLee, Bong Eun-
dc.contributor.authorJoo, Moon Kyung-
dc.contributor.authorPark, Jae Myung-
dc.contributor.authorShin, Woon Geon-
dc.contributor.authorLee, Hang Lak-
dc.contributor.authorGweon, Tae-Geun-
dc.contributor.authorPark, Moo In-
dc.contributor.authorChoi, Jeongmin-
dc.contributor.authorTae, Chung Hyun-
dc.contributor.authorKim, Young-Il-
dc.contributor.authorChoi, Il Ju-
dc.date.available2020-12-09T08:52:44Z-
dc.date.issued2021-01-
dc.identifier.issn1436-3291-
dc.identifier.issn1436-3305-
dc.identifier.urihttps://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/33912-
dc.description.abstractBackground This study aimed to investigate risk factors for lymph node (LN) or distant metastasis after non-curative endoscopic resection (ER) of undifferentiated-type early gastric cancer (EGC). Methods Of 1124 patients who underwent ER for undifferentiated-type gastric cancer at 18 tertiary hospitals across six geographic areas in Korea between 2005 and 2014, 634 with non-curative ER beyond the expanded criteria were retrospectively enrolled. According to the treatment after ER, patients were divided into additional surgery (n = 270) and follow-up (n = 364) groups. The median follow-up duration was 59 months for recurrence and 84 months for mortality. Results LN metastasis was found in 6.7% (18/270) of patients at surgery. Ulcer [odds ratio (OR) 3.83; 95% confidence interval (CI) 1.21–12.13; p = 0.022] and submucosal invasion (OR 10.35; 95% CI 1.35–79.48; p = 0.025) were independent risk factors. In the follow-up group, seven patients (1.9%) developed LN or distant recurrence. Ulcer [hazard ratio (HR) 7.60; 95% CI 1.39–35.74; p = 0.018], LVI (HR 6.80; 95% CI 1.07–42.99; p = 0.042), and positive vertical margin (HR 6.71; 95% CI 1.28–35.19; p = 0.024) were independent risk factors. In the overall cohort, LN metastasis rates were 9.6% in patients with two or more risk factors and 1.2% in those with no or one risk factor. Conclusions LVI, ulcer, submucosal invasion, and positive vertical margin are independently associated with LN or distant metastasis after non-curative ER of undifferentiated-type EGC. Surgical resection is strongly recommended for patients with two or more risk factors.-
dc.format.extent11-
dc.language영어-
dc.language.isoENG-
dc.publisherSPRINGER-
dc.titleRisk factors of lymph node metastasis after non-curative endoscopic resection of undifferentiated-type early gastric cancer-
dc.typeArticle-
dc.publisher.location미국-
dc.identifier.doi10.1007/s10120-020-01103-2-
dc.identifier.scopusid2-s2.0-85087445098-
dc.identifier.wosid000545310300002-
dc.identifier.bibliographicCitationGastric Cancer, v.24, no.1, pp 168 - 178-
dc.citation.titleGastric Cancer-
dc.citation.volume24-
dc.citation.number1-
dc.citation.startPage168-
dc.citation.endPage178-
dc.type.docTypeArticle; Early Access-
dc.description.isOpenAccessN-
dc.description.journalRegisteredClassscie-
dc.description.journalRegisteredClassscopus-
dc.relation.journalResearchAreaOncology-
dc.relation.journalResearchAreaGastroenterology & Hepatology-
dc.relation.journalWebOfScienceCategoryOncology-
dc.relation.journalWebOfScienceCategoryGastroenterology & Hepatology-
dc.subject.keywordPlusPOORLY DIFFERENTIATED ADENOCARCINOMA-
dc.subject.keywordPlusSUBMUCOSAL DISSECTION-
dc.subject.keywordPlusPREDICTIVE FACTORS-
dc.subject.keywordPlusFEASIBILITY-
dc.subject.keywordPlusOUTCOMES-
dc.subject.keywordPlusSURGERY-
dc.subject.keywordAuthorStomach neoplasms-
dc.subject.keywordAuthorUndifferentiated-type histology-
dc.subject.keywordAuthorNon-curative resection-
dc.subject.keywordAuthorLymph node Metastasis-
dc.subject.keywordAuthorRisk factors-
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