Lymph node metastasis in multiple synchronous early gastric cancer

Area of Science:

• Gastroenterology
• Surgical Oncology
• Endoscopic Procedures

Background:

• Endoscopic resection is increasingly used for early gastric cancer (EGC).
• Indications for endoscopic resection in multiple EGCs require further clarification.

Purpose of the Study:

• Compare clinicopathologic factors and lymph node (LN) metastasis risk between multiple and solitary EGCs.
• Evaluate the suitability of current endoscopic resection indications for multiple EGCs.

Main Methods:

• A case-control study involving 1717 patients (156 multiple EGCs, 1561 solitary EGCs).
• Analysis of gastrectomy with LN dissection data.
• Comparison of clinicopathologic features and LN metastasis incidence.

Main Results:

• Multiple EGCs showed similar tumor size, invasion depth, lymphovascular invasion, and LN metastasis rates compared to solitary EGCs.
• The risk of LN metastasis in multiple EGCs meeting endoscopic resection criteria was not significantly different from solitary EGCs.
• Tumor size ≥3 cm and lymphovascular invasion were independent risk factors for LN metastasis in multiple EGCs.

Conclusions:

• Multiple EGCs exhibit comparable clinicopathologic features and LN metastasis risk to solitary EGCs.
• Endoscopic resection is a potentially curative treatment for multiple EGCs that meet established indications.
• Further research is necessary to validate these findings.