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Multifocality in Early Gastric Cancer Does not Increase the Risk of Lymph Node Metastasis in a Single-Center Study

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The multifocality rate of EGC ranges from 4 to 20%, but there are few data regarding both lymph node metastasis and feasibility of the endoscopic treatment. We investigated the risk of lymph node metastasis with the purpose to evaluate the potential for endoscopic treatment in patients with multifocal EGC.

Methods

We retrospectively reviewed the medical records of patients who underwent radical gastrectomy to treat EGC between January 2001 and December 2007 at Severance Hospital, Seoul, Korea. Synchronous multifocal EGC was defined as EGC having two or more malignant foci, whereas solitary EGC was defined as EGC having single focus.

Results

Of 1,693 patients, 55 (3.2%) were diagnosed with synchronous multifocal EGC. The rates of lymph node metastasis were 12.7% in synchronous multifocal EGC and 10% in solitary EGC. In the multivariate analysis, synchronous multifocal EGC was not associated with lymph node metastasis (odds ratio, 1.1; 95% confidence interval, 0.4–2.7) compared with solitary EGC. In a subgroup analysis of 55 patients with synchronous multifocal EGC, older age (≥65 years) and lymphovascular invasion were associated with lymph node metastasis. In synchronous multifocal EGC, none of the cases had lymph node metastasis in major and minor lesions representing mucosal cancer without lymphovascular invasion.

Conclusions

Synchronous multifocality of EGC does not increase the risk of lymph node metastasis compared with solitary EGC. Therefore, endoscopic treatment can be planned when major and minor lesions are predicted to represent mucosal cancer without lymphovascular invasion.

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Acknowledgment

This research was supported (Jae Hee Cho) by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2011-0013944).

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Authors and Affiliations

  1. Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hee Man Kim MD, Jae Hee Cho MD & Young Hoon Youn MD

  2. Division of Gastroenterology, Department of Internal Medicine, Kwandong University College of Medicine, Goyang, Republic of Korea

    Hee Man Kim MD & Jae Hee Cho MD

  3. Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hyun Ki Kim MD

  4. Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Sang Kil Lee MD, Yong Chan Lee MD & Si Young Song MD

  5. Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea

    Kyung Ho Pak MD, Woo Jin Hyung MD, Sung Hoon Noh MD & Choong Bai Kim MD

  6. Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eonjuro, Gangnam-gu, Seoul, Republic of Korea

    Young Hoon Youn MD

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  1. Hee Man Kim MD
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  2. Hyun Ki Kim MD
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  3. Sang Kil Lee MD
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  4. Jae Hee Cho MD
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  5. Kyung Ho Pak MD
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  6. Woo Jin Hyung MD
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  7. Sung Hoon Noh MD
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  8. Choong Bai Kim MD
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  9. Yong Chan Lee MD
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  10. Si Young Song MD
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  11. Young Hoon Youn MD
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Corresponding author

Correspondence to Young Hoon Youn MD.

Additional information

Hee Man Kim and Hyun Ki Kim equally contributed to this study.

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Kim, H.M., Kim, H.K., Lee, S.K. et al. Multifocality in Early Gastric Cancer Does not Increase the Risk of Lymph Node Metastasis in a Single-Center Study. Ann Surg Oncol 19, 1251–1256 (2012). https://doi.org/10.1245/s10434-011-2083-7

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  • DOI: https://doi.org/10.1245/s10434-011-2083-7

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