The Characteristics, Prognosis, and Risk Factors of Lymph Node Metastasis in Early Gastric Cancer

Background. Lymph node metastasis (LNM) is the most important risk factor for endoscopic treatment in early gastric cancer (EGC) patients. We aimed to investigate the rate of LNM, the risk factors, and the prognosis of EGC patients with LMN. Methods. A total of 10,039 patients who underwent gastrect...

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Main Authors: Xuan Li, Shiyu Liu, Jin Yan, Lei Peng, Meihong Chen, Jiajia Yang, Guoxin Zhang
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2018/6945743
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author Xuan Li
Shiyu Liu
Jin Yan
Lei Peng
Meihong Chen
Jiajia Yang
Guoxin Zhang
author_facet Xuan Li
Shiyu Liu
Jin Yan
Lei Peng
Meihong Chen
Jiajia Yang
Guoxin Zhang
author_sort Xuan Li
collection DOAJ
description Background. Lymph node metastasis (LNM) is the most important risk factor for endoscopic treatment in early gastric cancer (EGC) patients. We aimed to investigate the rate of LNM, the risk factors, and the prognosis of EGC patients with LMN. Methods. A total of 10,039 patients who underwent gastrectomy with lymphadenectomy were reviewed between January 2010 and December 2015 at Jiangsu Province Hospital in China. Among them, we identified 1004 (10%) EGCs. First, endoscopic and clinicopathological features related to LNM were analyzed, and then risk factors for LNM were identified using univariate and multivariate analysis. Finally, the short- and long-term outcomes were compared between the groups. Results. LNM occurred in 123 (12.3%) EGCs. Most of EGCs were male (n=720, 71.7%) and mean age was 59.65 ± 11.09 years. The rate of H. pylori infection was 78.0% (783/1004). LNM was significantly associated with age, sex, location, lesion size, macroscopic type, depth of invasion, differentiation type, histological morphology, lymphovascular invasion (LVI), and TMN stage. By multivariate analysis, significant independent risk factors for LNM in EGC were identified as following: male sex (OR 2.365, P=0.035), age ≦ 40 (OR 0.055, P=0.012), depressed type (OR 2.721, P=0.013), submucosa invasion (OR 2.987, P=0.032), LVI (OR 5.186, P=0.003), tumor located in corpora (OR 8.904, P=0.047), and in angle (OR 12.998, P=0.024). 86.5% were successfully followed up for 3 years. The overall 1- and 3-year survival rates in LNM group were 100% and 91.1%, respectively, and those with no LNM were 100% and 100%, respectively. Conclusion. EGCs were investigated in 10.0% of gastric cancer, which LNM occurred in 12.3% of EGC. Independent risk factors of LNM included male sex, age (>40), the depth of invasion, LVI, and tumor located in corpora or angle. The 3-year overall survival rate was greater in EGC patients without LNM.
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spelling doaj-art-faae1e0ea2b945d594311053d8a3b1bb2025-08-20T02:22:37ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/69457436945743The Characteristics, Prognosis, and Risk Factors of Lymph Node Metastasis in Early Gastric CancerXuan Li0Shiyu Liu1Jin Yan2Lei Peng3Meihong Chen4Jiajia Yang5Guoxin Zhang6Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, ChinaDepartment of Gastroenterology, First People’s Hospital of Xuzhou, Xuzhou 221007, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, ChinaBackground. Lymph node metastasis (LNM) is the most important risk factor for endoscopic treatment in early gastric cancer (EGC) patients. We aimed to investigate the rate of LNM, the risk factors, and the prognosis of EGC patients with LMN. Methods. A total of 10,039 patients who underwent gastrectomy with lymphadenectomy were reviewed between January 2010 and December 2015 at Jiangsu Province Hospital in China. Among them, we identified 1004 (10%) EGCs. First, endoscopic and clinicopathological features related to LNM were analyzed, and then risk factors for LNM were identified using univariate and multivariate analysis. Finally, the short- and long-term outcomes were compared between the groups. Results. LNM occurred in 123 (12.3%) EGCs. Most of EGCs were male (n=720, 71.7%) and mean age was 59.65 ± 11.09 years. The rate of H. pylori infection was 78.0% (783/1004). LNM was significantly associated with age, sex, location, lesion size, macroscopic type, depth of invasion, differentiation type, histological morphology, lymphovascular invasion (LVI), and TMN stage. By multivariate analysis, significant independent risk factors for LNM in EGC were identified as following: male sex (OR 2.365, P=0.035), age ≦ 40 (OR 0.055, P=0.012), depressed type (OR 2.721, P=0.013), submucosa invasion (OR 2.987, P=0.032), LVI (OR 5.186, P=0.003), tumor located in corpora (OR 8.904, P=0.047), and in angle (OR 12.998, P=0.024). 86.5% were successfully followed up for 3 years. The overall 1- and 3-year survival rates in LNM group were 100% and 91.1%, respectively, and those with no LNM were 100% and 100%, respectively. Conclusion. EGCs were investigated in 10.0% of gastric cancer, which LNM occurred in 12.3% of EGC. Independent risk factors of LNM included male sex, age (>40), the depth of invasion, LVI, and tumor located in corpora or angle. The 3-year overall survival rate was greater in EGC patients without LNM.http://dx.doi.org/10.1155/2018/6945743
spellingShingle Xuan Li
Shiyu Liu
Jin Yan
Lei Peng
Meihong Chen
Jiajia Yang
Guoxin Zhang
The Characteristics, Prognosis, and Risk Factors of Lymph Node Metastasis in Early Gastric Cancer
Gastroenterology Research and Practice
title The Characteristics, Prognosis, and Risk Factors of Lymph Node Metastasis in Early Gastric Cancer
title_full The Characteristics, Prognosis, and Risk Factors of Lymph Node Metastasis in Early Gastric Cancer
title_fullStr The Characteristics, Prognosis, and Risk Factors of Lymph Node Metastasis in Early Gastric Cancer
title_full_unstemmed The Characteristics, Prognosis, and Risk Factors of Lymph Node Metastasis in Early Gastric Cancer
title_short The Characteristics, Prognosis, and Risk Factors of Lymph Node Metastasis in Early Gastric Cancer
title_sort characteristics prognosis and risk factors of lymph node metastasis in early gastric cancer
url http://dx.doi.org/10.1155/2018/6945743
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