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Combination of endoscopic submucosal dissection and laparoscopic sentinel lymph node dissection in early mucinous gastric cancer: Role of lymph node metastasis.
Li, Hua; Zhao, Li-Li; Zhang, Xiao-Chong; Liu, Deng-Xiang; Wang, Gui-Ying; Huo, Zhi-Bin; Chen, Shu-Bo.
Afiliación
  • Li H; Institute of Cancer Control, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China.
  • Zhao LL; Institute of Cancer Control, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China.
  • Zhang XC; Institute of Cancer Control, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China.
  • Liu DX; Institute of Cancer Control, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China.
  • Wang GY; Department of General Surgery, Fourth Affiliated Hospital of Hebei Medial University, Shijiazhuang 050000, Hebei Province, China.
  • Huo ZB; Institute of Cancer Control, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China. zhibinhwcwk@126.com.
  • Chen SB; Institute of Cancer Control, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China.
World J Clin Cases ; 8(16): 3474-3482, 2020 Aug 26.
Article en En | MEDLINE | ID: mdl-32913854
BACKGROUND: Recent evidence showed that combining endoscopic submucosal dissection (ESD) and laparoscopic sentinel lymph node dissection may avoid unnecessary gastrectomy in treating early mucinous gastric cancer (EMGC) patients with risks of positive lymph node metastasis (pLNM). AIM: To explore the predictive factors for pLNM in EMGC, and to optimize the clinical application of combing ESD and sentinel lymph node dissection in a proper subgroup of patients with EMGC. METHODS: Thirty-one patients with EMGC who had undergone gastrectomy with lymph node dissection were consecutively enrolled from January 1988 to December 2016. Univariate and multivariate logistic regression analyses were used to estimate the association between the rates of pLNM and clinicopathological factors, providing odds ratio (OR) with 95% confidence interval. And the association between the number of predictors and the pLNM rate was also investigated. RESULTS: Depth of invasion (OR = 7.342, 1.127-33.256, P = 0.039), tumor diameter (OR = 9.158, 1.348-29.133, P = 0.044), and lymphatic vessel involvement (OR = 27.749, 1.821-33.143, P = 0.019) turned out to be significant and might be the independent risk factors for predicating pLNM in the multivariate analysis. For patients with 1, 2, and 3 risk factors, the pLNM rates were 9.1%, 33.3%, and 75.0%, respectively. pLNM was not detected in seven patients without any of these risk factors. CONCLUSION: ESD might serve as a safe and sufficient treatment for intramucosal EMGC if tumor size ≤ 2 cm, and when lymphatic vessel involvement is absent by postoperative histological examination. Combining ESD and sentinel lymph node dissection could be recommended as a safe and effective treatment for EMGC patients with a potential risk of pLNM.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: World J Clin Cases Año: 2020 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: World J Clin Cases Año: 2020 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos