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Annals of Surgical Oncology

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01-10-2013 | Gastrointestinal Oncology

Risk of Limited Lymph Node Dissection in Patients with Clinically Early Gastric Cancer: Indications of Extended Lymph Node Dissection for Early Gastric Cancer

Authors: Han Hong Lee, MD, Han Mo Yoo, MD, Kyo Young Song, MD, Hae Myung Jeon, MD, Cho Hyun Park, MD

Published in: Annals of Surgical Oncology | Issue 11/2013

Abstract

Background

Laparoscopic gastrectomy is usually indicated in T1 N0–1 early gastric cancer (EGC). Limited lymph node dissection, such as D1+, is applied in these cases. However, preoperative staging is not always correct, and the risk of undertreatment thus exists.

Methods

Patients with clinically early gastric cancer (cEGC) who underwent gastrectomy with lymph node dissection of D2 and over were selected from 4,021 patients with gastric cancer. The station numbers of all metastatic lymph nodes (MLNs) were identified, and MLNs were classified into groups 1 and 2 (including lymph nodes of second tier and over) on the basis of the system of the Japanese Gastric Cancer Association, irrespective of the number of MLNs. Clinicopathological data were compared according to the existence of lymph node metastasis and the classification of MLNs.

Results

Of 1,308 patients with cEGC who fulfilled the inclusion criteria, 1,184 (90.5 %) were diagnosed pathologically with EGC. Among 126 patients with cEGC who were diagnosed with lymph node metastasis, 93 patients had only group 1 MLNs and 33 patients had group 2 MLNs. Tumor location in the proximal third of the stomach (odds ratio 5.450) and ulceration (odds ratio 11.928) were significant factors for group 2 metastasis.

Conclusions

Extended lymph node dissection is recommended in cEGC with ulceration or disease located in the proximal third of the stomach.

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Title: Risk of Limited Lymph Node Dissection in Patients with Clinically Early Gastric Cancer: Indications of Extended Lymph Node Dissection for Early Gastric Cancer
Authors: Han Hong Lee, MD
Han Mo Yoo, MD
Kyo Young Song, MD
Hae Myung Jeon, MD
Cho Hyun Park, MD
Publication date: 01-10-2013
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 11/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-013-3124-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk of Limited Lymph Node Dissection in Patients with Clinically Early Gastric Cancer: Indications of Extended Lymph Node Dissection for Early Gastric Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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