Bausys Rimantas, Bausys Augustinas, Maneikis Kazimieras, Belogorceva Viktorija, Stratilatovas Eugenijus, Strupas Kestutis
Faculty of Medicine, Vilnius University, Ciurlionio str, 21, Vilnius, Lithuania.
Department of Abdominal surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.
BMC Surg. 2018 Sep 25;18(1):79. doi: 10.1186/s12893-018-0414-3.
Endoscopic resection is widely accepted treatment option for early gastric cancer if tumors meet the standard or expanded indications. However, the safety of expanded criteria is still under investigation. Furthermore, discussion, if any additional treatment is necessary for patients who underwent endoscopic resection but exceeded expanded criteria, is rising. This study aimed to evaluate the safety of extended indications for endoscopic resection of early gastric cancer in a Western cohort. Also, we aimed to analyze the lymph node metastasis rate in tumors which exceeds the extended criteria.
Two hundred eighteen patients who underwent surgery for early gastric cancer at National Cancer Institute, Vilnius, Lithuania between 2005 and 2015 were identified from a prospective database. Lymph node status was examined in 197 patients who met or exceeded extended indications for endoscopic resection.
Lymph node metastasis was detected in 1.7% of cancers who met extended indications and in 30.2% of cancers who exceeded expanded indications. Lymphovascular invasion and deeper tumor invasion is associated with lymph node metastasis in cancers exceeding expanded indications.
Expanded criteria for endoscopic resection of early gastric cancer in Western settings is not entirely safe because these tumors carry the risk of lymph node metastasis.
如果肿瘤符合标准或扩展适应症，内镜切除术是早期胃癌广泛接受的治疗选择。然而，扩展标准的安全性仍在研究中。此外，对于接受内镜切除但超出扩展标准的患者是否需要任何额外治疗的讨论也在增加。本研究旨在评估西方队列中早期胃癌内镜切除扩展适应症的安全性。此外，我们旨在分析超出扩展标准的肿瘤中的淋巴结转移率。
从立陶宛维尔纽斯国立癌症研究所2005年至2015年期间接受早期胃癌手术的218例患者的前瞻性数据库中进行识别。对197例符合或超出内镜切除扩展适应症的患者检查淋巴结状态。
符合扩展适应症的癌症中1.7%检测到淋巴结转移，超出扩展适应症的癌症中30.2%检测到淋巴结转移。在超出扩展适应症的癌症中，淋巴管侵犯和更深的肿瘤侵犯与淋巴结转移相关。
西方环境中早期胃癌内镜切除的扩展标准并不完全安全，因为这些肿瘤存在淋巴结转移风险。
