AB02. Expanded endoscopic therapy criteria should be cautiously used in Chinese intramucosal gastric cancer
Zhenbin Shen, Cong Wang, Hongshan Wang, Yong Fang, Xuefei Wang, Zhaoqing Tang, Weidong Chen, Fenglin Liu, Yihong Sun, Xinyu Qin
Background: Accurate estimation of lymph node metastasis (LNM) in intramucosal gastric cancer is essential to select less invasive treatment options and even avoid surgery. The aim of this study was to evaluate combined clinicopathological features that predict the presence of LNM.
Methods: A retrospective review of data from 386 Chinese intramucosal gastric cancer patients who underwent D1+ or D2 gastrectomy from January 2003 through July 2010 was conducted. The mutual relation between clinicopathological characteristics and LNM were analyzed.
Results: LNM was detected in 40 (10.4%) of the 386 patients. Histological type and the presence of vascular or lymphatic invasion showed a positive correlation with the occurrence of LNM by univariate analysis. Multivariate analysis revealed histological type was the only factor associated with LNM. Combined clinicopathologic characteristics would be more predictable for LNM. No LNM was found when combined clinicopathological characteristics conforming to Japanese absolute indications for endoscopic therapy was used. The LNM rate was as high as 8.7% when Japanese expanded criteria were used. Univariate analysis in intramucosal gastric cancer conformity to expanded ESD indication also found undifferential type was the only significant factor for LNM.
Conclusions: To predict intramucosal gastric cancer cases without LNM was possible with combined clinicopathological characteristics analysis. Extended indication for ESD should be cautiously used for Chinese intramucosal gastric cancer patients.
Keywords: Gastric cancer; lymph node metastasis (LNM); intramucosal; pathological
