Applicability of endoscopic submucosal dissection for undifferentiated early gastric cancer: Mixed histology of poorly differentiated adenocarcinoma and signet ring cell carcinoma is a worse predictive factor of nodal metastasis
Applicability of endoscopic submucosal dissection for undifferentiated early gastric cancer: Mixed histology of poorly differentiated adenocarcinoma and signet ring cell carcinoma is a worse predictive factor of nodal metastasis
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DOI：
10.1016/j.suronc.2016.12.001
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发表时间：
2017-03-01
影响因子：
2.3
通讯作者：
Kim, Byung Sik
中科院分区：
文献类型：
--
作者：
Lee, In Seob;Lee, Sol;Kim, Byung Sik
背景资料：由于淋巴结转移的风险较高，内镜粘膜下剥离术（ESD）不被认为是未分化早期胃癌（UEGC）的适当治疗方法。我们的目的是研究UEGC淋巴结转移的预测因素，确定肿瘤组织学是否是其独立因素，并探讨ESD是否适用于UEGC。方法：我们回顾了2008年至2012年期间因低分化腺癌、印戒细胞癌和两种肿瘤混合型而接受根治性胃切除术的1837例患者的病历。结果：208例（11.3%）患者发现淋巴结转移。多变量分析显示，淋巴管浸润和肿瘤组织学与粘膜癌的淋巴结转移显著相关，混合型肿瘤的淋巴结转移率（6.3%）高于其他两种类型（2.0-2.5%; p = 0.005）。低分化腺癌未见淋巴结转移
Background: Endoscopic submucosal dissection (ESD) is not considered an appropriate treatment for undifferentiated early gastric cancer (UEGC) due to the higher risk of nodal metastases. We aimed to investigate predictive factors for nodal metastases in UEGCs, determine whether the tumor histology is an independent factor for it, and explore whether ESD is applicable for UEGC.Methods: We reviewed the medical records of 1837 patients who underwent curative gastrectomy for poorly differentiated adenocarcinoma, signet ring cell carcinoma, and a mixed type of both tumors between 2008 and 2012.Results: Nodal metastases were found in 208 (11.3%) patients. Multivariate analysis revealed that lymphovascular invasion and tumor histology were significantly associated with nodal metastases in mucosal cancers, the rates of which were higher in mixed type tumors (6.3%) than in the other two types (2.0-2.5%; p = 0.005). No nodal metastases were observed in poorly differentiated adenocarcinomas