Incidence of Lymph Node Metastasis from Early Gastric Cancer: Reappraisal of Japanese Criteria of EMR/ESD
JH Lee, HJ Kang, SH Chae, GH Kim, DY Park, DH Shin, KU Choi, CH Lee, GY Huh, MY Sol. Pusan National University Hospital, Busan, Korea
Background: With increasing use of endoscopic resection for therapeutic purpose in early gastric cancer (EGC) worldwide, it is very important to define strict criteria for EMR (endoscopic mucosal resection)/ESD (endoscopic submucosal dissection), due to most EMR/ESD criteria are based on Japanese data of lymph node (LN) metastasis in EGC.
Design: We tried to review incidence of LN metastasis in 485 EGC patients underwent gastrectomy with LN dissection at the Pusan National University Hospital during four years (275=mucosal(m) EGC, 210=submucosal(sm) EGC). Various clinicopathologic factors were analyzed with status of lymph node metastasis.
Results: Overall, there are 14.02% (68/485) of LN metastasis in EGC (mEGC=5.3% (14/275), smEGC=25.7% (54/210). Increased size, gross type (elevated), depth of invasion and lymphovascular tumor emboli are associated with LN metastasis in EGC. In 275 cases of mEGC, only lymphovascular emboli is associated with LN metastasis. In smEGC, size, depth of invasion and lymphovascular emboli are related to LN metastasis. Even there was LN metastasis (12/496, 4.05%) within EMR/ESD criteria by Japanese data (intestinal, sm1 invasion, no lymphovascular tumor emboli, less than 3cm in size).
Conclusions: Taken together, we recommend that more worldwide survey of LN metastasis of EGC is needed to define strict criteria of EMR/ESD for therapuetic purposes.
Tuesday, March 10, 2009 1:00 PM
Poster Session IV # 99, Tuesday Afternoon