ArticleSurgical endoscopy2021
Risk of lymph node metastasis in early gastric cancer and indications for endoscopic resection: is it worth applying the east rules to the west?
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Endoscopic resection or radical gastrectomy? Risk factors for lymph node metastasis in early gastric cancer: a systematic review and meta-analysis.World journal of surgical oncology · 2026Pooled it
- Incidence of lymph node metastases in pT1 chemo- and radiotherapy-naïve esophageal and gastric cancer in the Nordic countries: a retrospective multinational cohort analysis.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Observational
- Can the Japanese guidelines for endoscopic submucosal dissection be safely applied to Korean gastric cancer patients? A multicenter retrospective study based on the Korean Gastric Cancer Association nationwide survey.Annals of surgical treatment and research · 2025Article
- Nomogram for pre-procedural prediction of lymph node metastasis in patients with submucosal early gastric cancer.Surgical endoscopy · 2025Article
- Lymph node metastases in early gastric cancer: Japanese Gastric Cancer Treatment Guidelines can be used for endoscopic resection in the West.Endoscopy international open · 2025Article
- Surgical outcomes and long-term survival of laparoscopic distal gastrectomy at high-volume centers in Korea and China: a two-centered retrospective analysis.Surgery today · 2025Article
- Nomograms of risk prediction and prognosis for the T1-T2 stage gastric cancer with lymph node metastasis: a population-based study.Frontiers in medicine · 2025Article
- Analysis of lymph node metastasis and survival prognosis in early gastric cancer patients: A retrospective study.World journal of gastrointestinal surgery · 2024Article
- Risk Factors for Lymph Node Metastasis in a Western Series of Patients with Distal Early Gastric Cancer.Journal of clinical medicine · 2024Article
- The Effect of Systemic Immune-Inflammatory Index (SII) and Prognostic Nutritional Index (PNI) in Early Gastric Cancer.Journal of inflammation research · 2024Article
- Review
- Article
- A nomogram based on platelet-to-lymphocyte ratio for predicting lymph node metastasis in patients with early gastric cancer.Frontiers in oncology · 2023Article
- Using nomogram, decision tree, and deep learning models to predict lymph node metastasis in patients with early gastric cancer: a multi-cohort study.American journal of cancer research · 2023Article
- Early gastric cancer: A challenge in Western countries.World journal of gastroenterology · 2022Article
- A retrospective analysis based on multiple machine learning models to predict lymph node metastasis in early gastric cancer.Frontiers in oncology · 2022Article
- Application of Machine Learning Algorithms to Predict Lymph Node Metastasis in Early Gastric Cancer.Frontiers in medicine · 2021Article
- Higher Lymph Node Metastasis Rate and Poorer Prognosis of Intestinal-Type Gastric Cancer Compared to Diffuse-Type Gastric Cancer in Early-Onset Early-Stage Gastric Cancer: A Retrospective Study.Frontiers in medicine · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly gastric cancers are associated with lymph node metastasis (LNM) in 15% of cases. Risk factors for LNM are well established in Eastern countries. Less invasive treatments, such as endoscopic or surgical laparoscopic resection, are well accepted in Eastern countries and a matter of intense debate in the West, were indications for such treatments are still contested The objective of the study is to determine risk factors related to LNM and to validate endoscopic resection indications.
methodsThe study was a retrospective cohort of 178 patients with early gastric cancer who underwent gastrectomy. Clinical and pathological factors were analyzed. The new rules of ER from JGCA were applied to the studied cohort.
resultsLNM was present in 13.48% of the cases, 3.96% (3/76) in T1a tumors and 20.58% (21/102) in T1b tumors. In univariate analysis ulceration (p = 0.04), differentiation grade (p = 0.04), submucosal invasion (p = 0.001), lymphatic invasion (p < 0.001), and vascular invasion (p < 0.001) were associated with LNM. In multivariate analysis, differentiation grade (p = 0.005) and submucosal invasion (p = 0.005) were independent risk factors. One patient classified in the expanded criteria group and seven from the relative criteria group had LNM. There were no LNM for undifferentiated mucosal lesions without ulceration.
conclusionsUndifferentiated tumors and submucosal invasion are risks factors associated with LNM in early gastric cancer in our study. Endoscopic Resection or less invasive and radical surgical treatments are an option to be carefully considered.
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