Risk clinicopathological factors for lymph node metastasis in poorly differentiated early gastric cancer and their impact on laparoscopic wedge resection

AIM：To investigate the predictive factors of lymph node metastasis（LNM） in poorly differentiated early gastric cancer（EGC）,and enlarge the possibility of using laparoscopic wedge resection（LWR）.METHODS：We retrospectively analyzed 85 patients with poorly differentiated EGC who underwent surgical rese...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2012-11, Vol.18 (44), p.6489-6493
Main Authors: Huo, Zhi-Bin, Chen, Shu-Bo, Zhang, Jing, Li, Hua, Wu, Dian-Chao, Zhai, Tong-Shan, Luan, Shang-Feng
Format: Article
Language:English
Subjects:
Brief
Cell Differentiation
Chi-Square Distribution
Early Detection of Cancer
Female
Gastrectomy - methods
Humans
Logistic Models
Lymph Node Excision
Lymph Nodes - pathology
Lymph Nodes - surgery
Lymphatic Metastasis
Male
Middle Aged
Multivariate Analysis
Neoplasm Invasiveness
Odds Ratio
Retrospective Studies
Risk Factors
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Treatment Outcome
Tumor Burden
临床
分化
切除术
淋巴结
病理因素
胃癌
腹腔镜
风险因素
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Summary:AIM：To investigate the predictive factors of lymph node metastasis（LNM） in poorly differentiated early gastric cancer（EGC）,and enlarge the possibility of using laparoscopic wedge resection（LWR）.METHODS：We retrospectively analyzed 85 patients with poorly differentiated EGC who underwent surgical resection between January 1992 and December 2010.The association between the clinicopathological factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses.Odds ratios（OR） with 95%CI were calculated.We further examined the relationship between the positive number of the three significant predictive factors and the LNM rate.RESULTS：In the univariate analysis,tumor size（P = 0.011）,depth of invasion（P = 0.007） and lymphatic vessel involvement（P 0.001） were significantly associated with a higher rate of LNM.In the multivariate model,tumor size（OR = 7.125,95%CI：1.251-38.218,P = 0.041）,depth of invasion（OR = 16.624,95%CI：1.571-82.134,P = 0.036） and lymphatic vessel involvement（OR = 39.112,95%CI：1.745-123.671,P = 0.011） were found to be independently risk clinicopathological factors for LNM.Of the 85 patients diagnosed with poorly differentiated EGC,12（14.1%） had LNM.The LNM rates were 5.7%,42.9% and 57.1%,respectively in cases with one,two and three of the risk factors respectively in poorly differentiated EGC.There was no LNM in 29 patients without the three risk clinicopathological factors.CONCLUSION：LWR alone may be sufficient treatment for intramucosal poorly differentiated EGC if the tumor is less than or equal to 2.0 cm in size,and when lymphatic vessel involvement is absent at postoperative histological examination.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v18.i44.6489