Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Korea.
Department of General and Digestive Surgery, University Hospital "Virgen del Rocio", Seville, Spain.
J Surg Oncol. 2018 Dec;118(8):1257-1263. doi: 10.1002/jso.25279. Epub 2018 Oct 27.
Additional surgery should be done after non-curative endoscopic resection (ER) in early gastric cancer (EGC) due to the risk of lymph node metastasis (LNM). However, the distribution pattern of LNM in these patients is complicated and unpredictable. The aim of this study is to identify any different distribution patterns of LNM in patients with EGC who underwent additional surgery after non-curative (ER) comparing to those without ER.
Patients who underwent surgery for EGC between 2001 and 2016 were included. Enrolled patients were divided into two groups, those who underwent additional surgery after non-curative ER and those who underwent direct surgery without a history of ER. Demographics, tumor characteristics and LNM distribution pattern were analyzed.
Among 4295 patients with EGC, 404 patients had a history of preoperative ER, and 3891 patients did not. After the application of exclusion criteria, 23 (7.1%) of 322 patients undergoing additional surgery had LNM. The additional surgery group showed less LNM, fewer nodal stations and more restricted distribution pattern of LNM.
The distribution pattern of LNM in EGC is complicated. However, more restricted locoregional LNM could be expected in cases of additional surgery after non-curative ER than after direct surgery.
由于存在淋巴结转移（LNM）的风险，早期胃癌（EGC）患者在非治愈性内镜下切除（ER）后应进行额外的手术。然而，这些患者的 LNM 分布模式复杂且不可预测。本研究旨在确定与未接受 ER 的患者相比，在非治愈性（ER）后接受额外手术的 EGC 患者中 LNM 是否存在不同的分布模式。
纳入 2001 年至 2016 年间接受手术治疗的 EGC 患者。将入组患者分为两组，一组为非治愈性 ER 后接受额外手术的患者，另一组为无 ER 病史而直接手术的患者。分析患者的人口统计学、肿瘤特征和 LNM 分布模式。
在 4295 例 EGC 患者中，有 404 例患者术前接受过 ER，3891 例患者未接受过 ER。在应用排除标准后，23 例（7.1%）接受额外手术的 322 例患者存在 LNM。与直接手术相比，额外手术组的 LNM 更少，淋巴结站数更少，LNM 的分布模式更局限。
EGC 中 LNM 的分布模式较为复杂。然而，与直接手术相比，在非治愈性 ER 后进行额外手术时，可能会出现更局限的局部区域 LNM。
