Skip to main content
Erschienen in: Journal of Gastrointestinal Surgery 4/2017

24.01.2017 | Review Article

Predictive Factors for Lymph Node Metastasis in Undifferentiated Early Gastric Cancer: a Systematic Review and Meta-analysis

verfasst von: Xudong Zhao, Aizhen Cai, Hongqing Xi, Lin Chen, Zheng Peng, Peiyu Li, Na Liu, Jianxin Cui, Hua Li

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Less invasive surgery is gaining popularity for the treatment of early gastric cancer (EGC), but there are no definitive guidelines for the use of less invasive surgery for the treatment of undifferentiated EGC. The aims of this meta-analysis were to identify potential predictive factors for lymph node metastasis (LNM) in undifferentiated EGC and to guide the personalized therapeutic modality for patients with undifferentiated EGC.

Methods

An extensive search of the PubMed, Embase, and Cochrane Library databases was performed to identify relevant articles involving undifferentiated EGC and LNM. Eligible data were systematically reviewed through a meta-analysis using Review Manager 5.3.

Results

In total, 23 studies were included in this analysis. The meta-analysis found that the variables sex (female), age (greater than 60 years), tumor size (greater than 20 mm), depth of invasion (submucosal invasion), presence of lymphovascular involvement, presence of ulcer findings, histology type (non-signet ring carcinoma), and tumor location (not in the middle part of the stomach) were significantly associated with LNM.

Conclusions

Eight variables were identified as predictive factors for LNM in undifferentiated EGC. The significance of these variables should be further confirmed during the process of LNM in undifferentiated EGC patients for future clinical application.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Kubota H, Kotoh T, Masunaga R, Dhar DK, Shibakita M, Tachibana M, Kohno H, Nagasue N. Impact of screening survey of gastric cancer on clinicopathological features and survival: retrospective study at a single institution. Surgery. 2000;128(1):41-7.CrossRefPubMed Kubota H, Kotoh T, Masunaga R, Dhar DK, Shibakita M, Tachibana M, Kohno H, Nagasue N. Impact of screening survey of gastric cancer on clinicopathological features and survival: retrospective study at a single institution. Surgery. 2000;128(1):41-7.CrossRefPubMed
2.
Zurück zum Zitat Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14(2):101–12. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14(2):101–12.
3.
Zurück zum Zitat Park YD, Chung YJ, Chung HY, Yu W, Bae HI, Jeon SW, Cho CM, Tak WY, Kweon YO. Factors related to lymph node metastasis and the feasibility of endoscopic mucosal resection for treating poorly differentiated adenocarcinoma of the stomach. Endoscopy. 2008;40(1):7-10.CrossRefPubMed Park YD, Chung YJ, Chung HY, Yu W, Bae HI, Jeon SW, Cho CM, Tak WY, Kweon YO. Factors related to lymph node metastasis and the feasibility of endoscopic mucosal resection for treating poorly differentiated adenocarcinoma of the stomach. Endoscopy. 2008;40(1):7-10.CrossRefPubMed
4.
Zurück zum Zitat Lee JH, Choi IJ, Kook MC, Nam BH, Kim YW, Ryu KW. Risk factors for lymph node metastasis in patients with early gastric cancer and signet ring cell histology. Br J Surg. 2010;97(5):732-6.CrossRefPubMed Lee JH, Choi IJ, Kook MC, Nam BH, Kim YW, Ryu KW. Risk factors for lymph node metastasis in patients with early gastric cancer and signet ring cell histology. Br J Surg. 2010;97(5):732-6.CrossRefPubMed
5.
Zurück zum Zitat Kim JH, Lee YC, Kim H, Song KH, Lee SK, Cheon JH, Kim H, Hyung WJ, Noh SH, Kim CB, Chung JB. Endoscopic resection for undifferentiated early gastric cancer. Gastrointest Endosc. 2009;69(4):e1-9.CrossRefPubMed Kim JH, Lee YC, Kim H, Song KH, Lee SK, Cheon JH, Kim H, Hyung WJ, Noh SH, Kim CB, Chung JB. Endoscopic resection for undifferentiated early gastric cancer. Gastrointest Endosc. 2009;69(4):e1-9.CrossRefPubMed
6.
Zurück zum Zitat Kang HY, Kim SG, Kim JS, Jung HC, Song IS. Clinical outcomes of endoscopic submucosal dissection for undifferentiated early gastric cancer. Surg Endosc. 2010;24(3):509-16.CrossRefPubMed Kang HY, Kim SG, Kim JS, Jung HC, Song IS. Clinical outcomes of endoscopic submucosal dissection for undifferentiated early gastric cancer. Surg Endosc. 2010;24(3):509-16.CrossRefPubMed
7.
Zurück zum Zitat Li H, Chen L, Huo Z, Xi H, Cui J, Zhao X. Defining a Subgroup Treatable for Laparoscopic and Endoscopic Cooperative Surgery in Undifferentiated Early Gastric Cancer: the Role of Lymph Node Metastasis. J Gastrointest Surg. 2015;19(10):1763-8.CrossRefPubMed Li H, Chen L, Huo Z, Xi H, Cui J, Zhao X. Defining a Subgroup Treatable for Laparoscopic and Endoscopic Cooperative Surgery in Undifferentiated Early Gastric Cancer: the Role of Lymph Node Metastasis. J Gastrointest Surg. 2015;19(10):1763-8.CrossRefPubMed
8.
Zurück zum Zitat Pyo JH, Lee H, Min BH, Lee JH, Choi MG, Lee JH, Sohn TS, Bae JM, Kim KM, Ahn HS, Jung SH, Kim S, Kim JJ. A risk prediction model based on lymph-node metastasis in poorly differentiated-type intramucosal gastric cancer. PLoS ONE. 2016;11(5):e0156207. Pyo JH, Lee H, Min BH, Lee JH, Choi MG, Lee JH, Sohn TS, Bae JM, Kim KM, Ahn HS, Jung SH, Kim S, Kim JJ. A risk prediction model based on lymph-node metastasis in poorly differentiated-type intramucosal gastric cancer. PLoS ONE. 2016;11(5):e0156207.
9.
Zurück zum Zitat Kim KJ, Park SJ, Moon W, Park MI. Analysis of factors related to lymph node metastasis in undifferentiated early gastric cancer. Turk J Gastroenterol. 2011;22(2):139-44.CrossRefPubMed Kim KJ, Park SJ, Moon W, Park MI. Analysis of factors related to lymph node metastasis in undifferentiated early gastric cancer. Turk J Gastroenterol. 2011;22(2):139-44.CrossRefPubMed
10.
Zurück zum Zitat Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) Group. JAMA. 2000;283(15):2008-12.CrossRefPubMed Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) Group. JAMA. 2000;283(15):2008-12.CrossRefPubMed
11.
Zurück zum Zitat Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1-34.CrossRefPubMed Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1-34.CrossRefPubMed
13.
Zurück zum Zitat Abe N, Watanabe T, Sugiyama M, Yanagida O, Masaki T, Mori T, Atomi Y. Endoscopic treatment or surgery for undifferentiated early gastric cancer? Am J Surg. 2004;188(2):181-4.CrossRefPubMed Abe N, Watanabe T, Sugiyama M, Yanagida O, Masaki T, Mori T, Atomi Y. Endoscopic treatment or surgery for undifferentiated early gastric cancer? Am J Surg. 2004;188(2):181-4.CrossRefPubMed
14.
Zurück zum Zitat Asakawa Y, Ohtaka M, Maekawa S, Fukasawa M, Nakayama Y, Yamaguchi T, Inoue T, Uetake T, Sakamoto M, Sato T, Kawaguchi Y, Fujii H, Mochizuki K, Hada M, Oyama T, Yasumura T, Omata K, Nishiyama A, Naito K, Hata H, Haba Y, Miyata K, Saitoh H, Yamadera Y, Miura K, Kawaoi A, Abe T, Tsunoda H, Honda Y, Kurosaki M, Enomoto N. Stratifying the risk of lymph node metastasis in undifferentiated-type early gastric cancer. World J Gastroenterol. 2015;21(9):2683-92.CrossRefPubMedPubMedCentral Asakawa Y, Ohtaka M, Maekawa S, Fukasawa M, Nakayama Y, Yamaguchi T, Inoue T, Uetake T, Sakamoto M, Sato T, Kawaguchi Y, Fujii H, Mochizuki K, Hada M, Oyama T, Yasumura T, Omata K, Nishiyama A, Naito K, Hata H, Haba Y, Miyata K, Saitoh H, Yamadera Y, Miura K, Kawaoi A, Abe T, Tsunoda H, Honda Y, Kurosaki M, Enomoto N. Stratifying the risk of lymph node metastasis in undifferentiated-type early gastric cancer. World J Gastroenterol. 2015;21(9):2683-92.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Chung JW, Jung HY, Choi KD, Song HJ, Lee GH, Jang SJ, Park YS, Yook JH, Oh ST, Kim BS, Kim JH. Extended indication of endoscopic resection for mucosal early gastric cancer: analysis of a single center experience. J Gastroenterol Hepatol (Australia). 2011;26(5):884-7.CrossRef Chung JW, Jung HY, Choi KD, Song HJ, Lee GH, Jang SJ, Park YS, Yook JH, Oh ST, Kim BS, Kim JH. Extended indication of endoscopic resection for mucosal early gastric cancer: analysis of a single center experience. J Gastroenterol Hepatol (Australia). 2011;26(5):884-7.CrossRef
16.
Zurück zum Zitat Feng H, Wang Y, Cao L, Zhang C, Sun B, Zhao Y, Xu J. Lymph node metastasis in differentiated-type early gastric cancer: a single-center retrospective analysis of surgically resected cases. Scand J Gastroenterol. 2016;51(1):48-54.CrossRefPubMed Feng H, Wang Y, Cao L, Zhang C, Sun B, Zhao Y, Xu J. Lymph node metastasis in differentiated-type early gastric cancer: a single-center retrospective analysis of surgically resected cases. Scand J Gastroenterol. 2016;51(1):48-54.CrossRefPubMed
17.
Zurück zum Zitat Guo CG, Zhao DB, Liu Q, Zhou ZX, Zhao P, Wang GQ, Cai JQ. Risk factors for lymph node metastasis in early gastric cancer with signet ring cell carcinoma. J Gastrointest Surg. 2015;19(11):1958-65.CrossRefPubMed Guo CG, Zhao DB, Liu Q, Zhou ZX, Zhao P, Wang GQ, Cai JQ. Risk factors for lymph node metastasis in early gastric cancer with signet ring cell carcinoma. J Gastrointest Surg. 2015;19(11):1958-65.CrossRefPubMed
18.
Zurück zum Zitat Ha TK, An JY, Youn HK, Noh JH, Sohn TS, Kim S. Indication for endoscopic mucosal resection in early signet ring cell gastric cancer. Ann Surg Oncol. 2008;15(2):508-13.CrossRefPubMed Ha TK, An JY, Youn HK, Noh JH, Sohn TS, Kim S. Indication for endoscopic mucosal resection in early signet ring cell gastric cancer. Ann Surg Oncol. 2008;15(2):508-13.CrossRefPubMed
19.
Zurück zum Zitat Hirasawa T, Gotoda T, Miyata S, Kato Y, Shimoda T, Taniguchi H, Fujisaki J, Sano T, Yamaguchi T. Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer. Gastric Cancer. 2009;12(3):148-52.CrossRefPubMed Hirasawa T, Gotoda T, Miyata S, Kato Y, Shimoda T, Taniguchi H, Fujisaki J, Sano T, Yamaguchi T. Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer. Gastric Cancer. 2009;12(3):148-52.CrossRefPubMed
20.
Zurück zum Zitat Ishikawa S, Togashi A, Inoue M, Honda S, Nozawa F, Toyama E, Miyanari N, Tabira Y, Baba H. Indications for EMR/ESD in cases of early gastric cancer: Relationship between histological type, depth of wall invasion, and lymph node metastasis. Gastric Cancer. 2007;10(1):35-8.CrossRefPubMed Ishikawa S, Togashi A, Inoue M, Honda S, Nozawa F, Toyama E, Miyanari N, Tabira Y, Baba H. Indications for EMR/ESD in cases of early gastric cancer: Relationship between histological type, depth of wall invasion, and lymph node metastasis. Gastric Cancer. 2007;10(1):35-8.CrossRefPubMed
21.
Zurück zum Zitat Jin EH, Lee DH, Jung SA, Shim KN, Seo JY, Kim N, Shin CM, Yoon H, Jung HC. Clinicopathologic factors and molecular markers related to lymph node metastasis in early gastric cancer. World J Gastroenterol. 2015;21(2):563-9.CrossRef Jin EH, Lee DH, Jung SA, Shim KN, Seo JY, Kim N, Shin CM, Yoon H, Jung HC. Clinicopathologic factors and molecular markers related to lymph node metastasis in early gastric cancer. World J Gastroenterol. 2015;21(2):563-9.CrossRef
22.
Zurück zum Zitat Kim HM, Pak KH, Chung MJ, Cho JH, Hyung WJ, Noh SH, Kim CB, Lee YC, Song SY, Lee SK. Early gastric cancer of signet ring cell carcinoma is more amenable to endoscopic treatment than is early gastric cancer of poorly differentiated tubular adenocarcinoma in select tumor conditions. Surgical Endoscopy and Other Interventional Techniques. 2011;25(9):3087-93.CrossRefPubMed Kim HM, Pak KH, Chung MJ, Cho JH, Hyung WJ, Noh SH, Kim CB, Lee YC, Song SY, Lee SK. Early gastric cancer of signet ring cell carcinoma is more amenable to endoscopic treatment than is early gastric cancer of poorly differentiated tubular adenocarcinoma in select tumor conditions. Surgical Endoscopy and Other Interventional Techniques. 2011;25(9):3087-93.CrossRefPubMed
23.
Zurück zum Zitat Kunisaki C, Takahashi M, Nagahori Y, Fukushima T, Makino H, Takagawa R, Kosaka T, Ono HA, Akiyama H, Moriwaki Y, Nakano A. Risk factors for lymph node metastasis in histologically poorly differentiated type early gastric cancer. Endoscopy. 2009;41(6):498-503.CrossRefPubMed Kunisaki C, Takahashi M, Nagahori Y, Fukushima T, Makino H, Takagawa R, Kosaka T, Ono HA, Akiyama H, Moriwaki Y, Nakano A. Risk factors for lymph node metastasis in histologically poorly differentiated type early gastric cancer. Endoscopy. 2009;41(6):498-503.CrossRefPubMed
24.
Zurück zum Zitat Lee T, Tanaka H, Ohira M, Okita Y, Yoshii M, Sakurai K, Toyokawa T, Kubo N, Muguruma K, Tanaka S, Ohsawa M, Hirakawa K. Clinical impact of the extent of lymph node micrometastasis in undifferentiated-type early gastric cancer. Oncology. 2014;86(4):244-52.CrossRefPubMed Lee T, Tanaka H, Ohira M, Okita Y, Yoshii M, Sakurai K, Toyokawa T, Kubo N, Muguruma K, Tanaka S, Ohsawa M, Hirakawa K. Clinical impact of the extent of lymph node micrometastasis in undifferentiated-type early gastric cancer. Oncology. 2014;86(4):244-52.CrossRefPubMed
25.
Zurück zum Zitat Li C, Kim S, Lai JF, Oh SJ, Hyung WJ, Choi WH, Choi SH, Zhu ZG, Noh SH. Risk factors for lymph node metastasis in undifferentiated early gastric cancer. Ann Surg Oncol. 2008;15(3):764-9.CrossRefPubMed Li C, Kim S, Lai JF, Oh SJ, Hyung WJ, Choi WH, Choi SH, Zhu ZG, Noh SH. Risk factors for lymph node metastasis in undifferentiated early gastric cancer. Ann Surg Oncol. 2008;15(3):764-9.CrossRefPubMed
26.
Zurück zum Zitat Namieno T, Koito K, Higashi T, Takahashi M, Yamashita K, Kondo Y. Assessing the suitability of gastric carcinoma for limited resection: endoscopic prediction of lymph node metastases. World J Surg. 1998;22(8):859-64.CrossRefPubMed Namieno T, Koito K, Higashi T, Takahashi M, Yamashita K, Kondo Y. Assessing the suitability of gastric carcinoma for limited resection: endoscopic prediction of lymph node metastases. World J Surg. 1998;22(8):859-64.CrossRefPubMed
27.
Zurück zum Zitat Nasu J, Nishina T, Hirasaki S, Moriwaki T, Hyodo I, Kurita A, Nishimura R. Predictive factors of lymph node metastasis in patients with undifferentiated early gastric cancers. J Clin Gastroenterol. 2006;40(5):412-5.CrossRefPubMed Nasu J, Nishina T, Hirasaki S, Moriwaki T, Hyodo I, Kurita A, Nishimura R. Predictive factors of lymph node metastasis in patients with undifferentiated early gastric cancers. J Clin Gastroenterol. 2006;40(5):412-5.CrossRefPubMed
28.
Zurück zum Zitat Park JM, Kim SW, Nam KW, Cho YK, Lee IS, Choi MG, Chung IS, Song KY, Park CH, Jung CK. Is it reasonable to treat early gastric cancer with signet ring cell histology by endoscopic resection? Analysis of factors related to lymph-node metastasis. Eur J Gastroenterol Hepatol. 2009;21(10):1132-5.CrossRefPubMed Park JM, Kim SW, Nam KW, Cho YK, Lee IS, Choi MG, Chung IS, Song KY, Park CH, Jung CK. Is it reasonable to treat early gastric cancer with signet ring cell histology by endoscopic resection? Analysis of factors related to lymph-node metastasis. Eur J Gastroenterol Hepatol. 2009;21(10):1132-5.CrossRefPubMed
29.
Zurück zum Zitat Tong JH, Sun Z, Wang ZN, Zhao YH, Huang BJ, Li K, Xu Y, Xu HM. Early gastric cancer with signet-ring cell histologic type: risk factors of lymph node metastasis and indications of endoscopic surgery. Surgery. 2011;149(3):356-63.CrossRefPubMed Tong JH, Sun Z, Wang ZN, Zhao YH, Huang BJ, Li K, Xu Y, Xu HM. Early gastric cancer with signet-ring cell histologic type: risk factors of lymph node metastasis and indications of endoscopic surgery. Surgery. 2011;149(3):356-63.CrossRefPubMed
30.
Zurück zum Zitat Wang Z, Zhang X, Hu J, Zeng W, Liang J, Zhou H, Zhou Z. Predictive factors for lymph node metastasis in early gastric cancer with signet ring cell histology and their impact on the surgical strategy: analysis of single institutional experience. J Surg Res. 2014;191(1):130-3.CrossRefPubMed Wang Z, Zhang X, Hu J, Zeng W, Liang J, Zhou H, Zhou Z. Predictive factors for lymph node metastasis in early gastric cancer with signet ring cell histology and their impact on the surgical strategy: analysis of single institutional experience. J Surg Res. 2014;191(1):130-3.CrossRefPubMed
31.
Zurück zum Zitat Ye BD, Kim SG, Lee JY, Kim JS, Yang HK, Kim WH, Jung HC, Lee KU, Song IS. Predictive factors for lymph node metastasis and endoscopic treatment strategies for undifferentiated early gastric cancer. J Gastroenterol Hepatol. 2008;23(1):46-50.PubMed Ye BD, Kim SG, Lee JY, Kim JS, Yang HK, Kim WH, Jung HC, Lee KU, Song IS. Predictive factors for lymph node metastasis and endoscopic treatment strategies for undifferentiated early gastric cancer. J Gastroenterol Hepatol. 2008;23(1):46-50.PubMed
32.
Zurück zum Zitat Sung CM, Hsu CM, Hsu JT, Yeh TS, Lin CJ, Chen TC, Su MY, Chiu CT. Predictive factors for lymph node metastasis in early gastric cancer. World J Gastroenterol. 2010;16(41):5252-6.CrossRefPubMedPubMedCentral Sung CM, Hsu CM, Hsu JT, Yeh TS, Lin CJ, Chen TC, Su MY, Chiu CT. Predictive factors for lymph node metastasis in early gastric cancer. World J Gastroenterol. 2010;16(41):5252-6.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Park J, Choi KD, Kim MY, Lee JH, Song HJ, Lee GH, Jung HY, Kim JH. Is endoscopic resection an acceptable treatment for undifferentiated EGC? Hepato-Gastroenterology. 2012;59(114):607-11.PubMed Park J, Choi KD, Kim MY, Lee JH, Song HJ, Lee GH, Jung HY, Kim JH. Is endoscopic resection an acceptable treatment for undifferentiated EGC? Hepato-Gastroenterology. 2012;59(114):607-11.PubMed
34.
Zurück zum Zitat Huo ZB, Chen SB, Zhang J, Li H, Wu DC, Zhai TS, Luan SF. Risk clinicopathological factors for lymph node metastasis in poorly differentiated early gastric cancer and their impact on laparoscopic wedge resection. World J Gastroenterol. 2012;18(44):6489–93; discussion p. 92. Huo ZB, Chen SB, Zhang J, Li H, Wu DC, Zhai TS, Luan SF. Risk clinicopathological factors for lymph node metastasis in poorly differentiated early gastric cancer and their impact on laparoscopic wedge resection. World J Gastroenterol. 2012;18(44):6489–93; discussion p. 92.
35.
Zurück zum Zitat Lee JH, Choi MG, Min BH, Noh JH, Sohn TS, Bae JM, Kim S. Predictive factors for lymph node metastasis in patients with poorly differentiated early gastric cancer. Br J Surg. 2012;99(12):1688-92.CrossRefPubMed Lee JH, Choi MG, Min BH, Noh JH, Sohn TS, Bae JM, Kim S. Predictive factors for lymph node metastasis in patients with poorly differentiated early gastric cancer. Br J Surg. 2012;99(12):1688-92.CrossRefPubMed
36.
Zurück zum Zitat Abe N, Watanabe T, Suzuki K, Machida H, Toda H, Nakaya Y, Masaki T, Mori T, Sugiyama M, Atomi Y. Risk factors predictive of lymph node metastasis in depressed early gastric cancer. Am J Surg. 2002;183(2):168-72.CrossRefPubMed Abe N, Watanabe T, Suzuki K, Machida H, Toda H, Nakaya Y, Masaki T, Mori T, Sugiyama M, Atomi Y. Risk factors predictive of lymph node metastasis in depressed early gastric cancer. Am J Surg. 2002;183(2):168-72.CrossRefPubMed
37.
Zurück zum Zitat Matsui M, Kojima O, Kawakami S, Uehara Y, Takahashi T. The prognosis of patients with gastric cancer possessing sex hormone receptors. Surg Today. 1992;22(5):421-5.CrossRefPubMed Matsui M, Kojima O, Kawakami S, Uehara Y, Takahashi T. The prognosis of patients with gastric cancer possessing sex hormone receptors. Surg Today. 1992;22(5):421-5.CrossRefPubMed
38.
Zurück zum Zitat Camargo MC, Goto Y, Zabaleta J, Morgan DR, Correa P, Rabkin CS. Sex hormones, hormonal interventions, and gastric cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2012;21(1):20-38.CrossRefPubMed Camargo MC, Goto Y, Zabaleta J, Morgan DR, Correa P, Rabkin CS. Sex hormones, hormonal interventions, and gastric cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2012;21(1):20-38.CrossRefPubMed
39.
Zurück zum Zitat Huo Z, Wu D, Li H, Zhai T, Luan S, Mu B, Wang S, Guo S. Risk factors of lymph node metastasis and laparoscopic wedge resection in early poorly differentiated gastric cancer. Chin J Clin Oncol. 2012;39(19):1418-9+25. Huo Z, Wu D, Li H, Zhai T, Luan S, Mu B, Wang S, Guo S. Risk factors of lymph node metastasis and laparoscopic wedge resection in early poorly differentiated gastric cancer. Chin J Clin Oncol. 2012;39(19):1418-9+25.
40.
Zurück zum Zitat Li H, Lu P, Lu Y, Liu C, Xu H, Wang S, Chen J. Predictive factors of lymph node metastasis in undifferentiated early gastric cancers and application of endoscopic mucosal resection. Surgical Oncology. 2010;19(4):221-6.CrossRefPubMed Li H, Lu P, Lu Y, Liu C, Xu H, Wang S, Chen J. Predictive factors of lymph node metastasis in undifferentiated early gastric cancers and application of endoscopic mucosal resection. Surgical Oncology. 2010;19(4):221-6.CrossRefPubMed
41.
Zurück zum Zitat Okabayashi T, Kobayashi M, Nishimori I, Sugimoto T, Namikawa T, Onishi S, Hanazaki K. Clinicopathological features and medical management of early gastric cancer. Am J Surg. 2008;195(2):229-32.CrossRefPubMed Okabayashi T, Kobayashi M, Nishimori I, Sugimoto T, Namikawa T, Onishi S, Hanazaki K. Clinicopathological features and medical management of early gastric cancer. Am J Surg. 2008;195(2):229-32.CrossRefPubMed
42.
Zurück zum Zitat Lehnert T, Erlandson RA, Decosse JJ. Lymph and blood capillaries of the human gastric mucosa. A morphologic basis for metastasis in early gastric carcinoma. Gastroenterology. 1985;89(5):939-50.CrossRefPubMed Lehnert T, Erlandson RA, Decosse JJ. Lymph and blood capillaries of the human gastric mucosa. A morphologic basis for metastasis in early gastric carcinoma. Gastroenterology. 1985;89(5):939-50.CrossRefPubMed
43.
Zurück zum Zitat Yamao T, Shirao K, Ono H, Kondo H, Saito D, Yamaguchi H, Sasako M, Sano T, Ochiai A, Yoshida S. Risk factors for lymph node metastasis from intramucosal gastric carcinoma. Cancer. 1996;77(4):602-6.CrossRefPubMed Yamao T, Shirao K, Ono H, Kondo H, Saito D, Yamaguchi H, Sasako M, Sano T, Ochiai A, Yoshida S. Risk factors for lymph node metastasis from intramucosal gastric carcinoma. Cancer. 1996;77(4):602-6.CrossRefPubMed
44.
Zurück zum Zitat Hölscher AH, Drebber U, Mönig SP, Schulte C, Vallböhmer D, Bollschweiler E. Early gastric cancer: lymph node metastasis starts with deep mucosal infiltration. Ann Surg. 2009;250(5):791-6.CrossRefPubMed Hölscher AH, Drebber U, Mönig SP, Schulte C, Vallböhmer D, Bollschweiler E. Early gastric cancer: lymph node metastasis starts with deep mucosal infiltration. Ann Surg. 2009;250(5):791-6.CrossRefPubMed
45.
Zurück zum Zitat Young B. Circulatory system. In: Young B, Heath JW, eds. Wheater’s Functional Histology. Edinburgh: Churchill Livingstone; 2000:144–56. Young B. Circulatory system. In: Young B, Heath JW, eds. Wheater’s Functional Histology. Edinburgh: Churchill Livingstone; 2000:144–56.
46.
Zurück zum Zitat Japanese Gastric Cancer Association. Treatment Guideline for Gastric Cancer in Japan (in Japanese) (2nd edn). Tokyo: Kanehara. Japanese Gastric Cancer Association. Treatment Guideline for Gastric Cancer in Japan (in Japanese) (2nd edn). Tokyo: Kanehara.
47.
Zurück zum Zitat Kwee RM, Kwee TC. Predicting lymph node status in early gastric cancer. Gastric Cancer. 2008;11(3):134-48.CrossRefPubMed Kwee RM, Kwee TC. Predicting lymph node status in early gastric cancer. Gastric Cancer. 2008;11(3):134-48.CrossRefPubMed
48.
Zurück zum Zitat Li H, Lu P, Lu Y, Liu CG, Xu HM, Wang SB, Chen JQ. Predictive factors for lymph node metastasis in poorly differentiated early gastric cancer and their impact on the surgical strategy. World J Gastroenterol. 2008;14(26):4222-6.CrossRefPubMedPubMedCentral Li H, Lu P, Lu Y, Liu CG, Xu HM, Wang SB, Chen JQ. Predictive factors for lymph node metastasis in poorly differentiated early gastric cancer and their impact on the surgical strategy. World J Gastroenterol. 2008;14(26):4222-6.CrossRefPubMedPubMedCentral
49.
Zurück zum Zitat Griffin SM. Gastric cancer in the East: same disease, different patient. Br J Surg. 2005;92(9):1055-6.CrossRefPubMed Griffin SM. Gastric cancer in the East: same disease, different patient. Br J Surg. 2005;92(9):1055-6.CrossRefPubMed
Metadaten
Titel
Predictive Factors for Lymph Node Metastasis in Undifferentiated Early Gastric Cancer: a Systematic Review and Meta-analysis
verfasst von
Xudong Zhao
Aizhen Cai
Hongqing Xi
Lin Chen
Zheng Peng
Peiyu Li
Na Liu
Jianxin Cui
Hua Li
Publikationsdatum
24.01.2017
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 4/2017
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-017-3364-7

Weitere Artikel der Ausgabe 4/2017

Journal of Gastrointestinal Surgery 4/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.