Influence of Tumor Location on Lymph Node Metastasis and Survival for Early Gastric Cancer: a Population-Based Study
Influence of Tumor Location on Lymph Node Metastasis and Survival for Early Gastric Cancer: a Population-Based Study
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DOI：
10.1007/s11605-019-04367-x
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发表时间：
2020-09-01
影响因子：
3.2
通讯作者：
Wang ChunXi
中科院分区：
文献类型：
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作者：
Yang ZeLong;Chang ZhenYu;Wang ChunXi
背景早期胃非贲门癌（GNCC）内镜切除术的标准是否适用于早期贲门癌（GCC）的问题尚不清楚。因此，我们的目的是评估肿瘤位置对早期胃癌（GC）淋巴结转移（LNM）和总生存期（OS）的影响。方法对监测、流行病学和最终结果（SEER）数据库中的5440例早期胃癌患者进行鉴定。采用多因素分析法评价肿瘤部位对早期胃癌LNM和OS的影响。结果早期GCC患者LNM发生率为17.48%（232/1327），早期GNCC患者LNM发生率为18.62%（766/4113）。早期GCC患者发生LNM的风险与早期GNCC患者相比无显著差异（校正OR 0.92，95%CI 0.76- 1.12，P = 0.405）。早期胃癌患者进一步分层的节点状态。肿瘤部位不是淋巴结阴性早期胃癌患者OS的预测因子（校正后HR为1.07，95%CI为0.96- 1.21，P = 0.225），但可预测淋巴结阳性早期胃癌患者OS（校正后HR为1.80，95%CI为1.48- 2.20，P < 0.001）。结论肿瘤部位不是早期胃癌LNM的预测因子。此外，对于淋巴结阴性的早期GC患者，肿瘤位置不是OS的预测因子。因此，早期GNCC的内镜切除标准可能适用于早期GCC的治疗。
Background The question that whether the criteria for endoscopic resection of early gastric non-cardia cancer (GNCC) is appropriate for early gastric cardia cancer (GCC) remains unclear. Thus, our aim was to evaluate the influence of tumor location on lymph node metastasis (LNM) and overall survival (OS) for early gastric cancer (GC). Methods A total of 5440 early GC patients in the Surveillance, Epidemiology, and End Results (SEER) database were identified. Multivariable analysis was performed to evaluate the influence of tumor location on LNM and OS for early GC. Results The rate of LNM was 17.48% for early GCC patients (232/1327) and 18.62% for early GNCC patients (766/4113). The early GCC patients experienced no significantly different risk of LNM compared with the early GNCC patients (adjusted OR 0.92, 95% CI 0.76-1.12,P = 0.405). The early GC patients were further stratified by node status. Tumor location was not a predictor of OS for node-negative early GC patients (adjusted HR 1.07, 95% CI 0.96-1.21,P = 0.225) but a predictor of OS for node-positive early GC patients (adjusted HR 1.80, 95% CI 1.48-2.20,P < 0.001). Conclusions Tumor location was not a predictor of LNM for early GC patients. Moreover, tumor location was not a predictor of OS for node-negative early GC patients. Thus, the criteria for endoscopic resection of early GNCC might be appropriate for the treatment of early GCC.