Clinicopathological features, risk of lymph node metastasis and survival outcome of synchronous multiple early gastric cancer - 22/11/20
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Highlights |
• | The prevalence of synchronous multiple lesions is not uncommon in early gastric cancer. |
• | Multiple early gastric cancer patients have a similar risk of lymph node metastasis and survival outcome in comparison to those with solitary tumor. |
• | Endoscopic resection may be equally suitable for multiple early gastric cancer patients if the lesions fulfill its indication criteria. |
Summary |
Objective |
To determine clinicopathological features, risk of lymph node metastasis (LNM) and survival outcome in synchronous multiple early gastric cancer (MEGC) patients.
Methods |
A total of 338 solitary early gastric cancer (SEGC) and 26 MEGC patients who underwent surgical resection were retrospectively reviewed. The clinicopathological features and predictive factors for MEGC patients were evaluated. Also, we analyzed risk factors for LNM and compared survival difference between SEGC and MEGC patients.
Results |
The frequency of multiple synchronous lesions was 7.1% in early gastric cancer (EGC) patients. The main and minor lesions were mostly confined to the same third of the stomach (84.6%, 22/26), and the most common location was the lower third of the stomach. With regard to the number of coexisting lesions, most of the patients had two lesions and more than three lesions were not common. Tumor size≤2cm (OR:2.684, 95%CI:1.131–6.368, P<0.05) and the presence of atrophic gastritis (OR:2.418, 95%CI:1.052–5.555, P<0.05) were independent risk factors for synchronous MEGC. There was no significant statistical difference between SEGC and MEGC for LNM (17.5% vs 23.1%, P=0.311). The number of coexisting lesions was not associated with the risk of LNM in EGC. In addition, the survival outcome of MEGC patients was similar to that of SEGC (5-year RFS rate, 96.0% vs 93.7%, P=0.329;5-year OS rate, 96.0% vs 88.3%, P=0.479).
Conclusion |
Meticulous endoscopic examination at the initial diagnosis of MEGC was very important, especially for those with precancerous lesions such as atrophic gastritis. In terms of treatment methods, endoscopic resection may be equally suitable for synchronous MEGC if the lesions fulfilled its indication criteria.
Le texte complet de cet article est disponible en PDF.Keywords : Early gastric cancer, Synchronous multiple gastric cancer, Lymph node metastasis, Endoscopic resection, Survival
Plan
Vol 44 - N° 6
P. 939-946 - novembre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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