Clinical significance of regional lymph node enlargement in patients with EGC within the expanded criteria for ESD

s Background Lymph node (LN) metastasis is negligible in early gastric cancer (EGC) within expanded criteria for endoscopic submucosal dissection (ESD). However, regional lymph nodes in abdominal CT scans are sometimes enlarged in patients with EGC within the expanded criteria for endoscopic submuco...

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Vydané v:BMC gastroenterology Ročník 20; číslo 1; s. 51 - 8
Hlavní autori: Lee, Dong Seok, Park, Jong Kyu, Lee, Sang Jin, Cheon, Gab Jin
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: London BioMed Central 05.03.2020
BioMed Central Ltd
Springer Nature B.V
BMC
Predmet:
Abdomen
Aged
Biopsy
Cancer
Cancer metastasis
CAT scans
Clinical significance
Diagnosis
Diagnostic imaging
Early Detection of Cancer
Early gastric cancer
Electrocardiography
Endoscopic Mucosal Resection
Endoscopic resection
Endoscopy
Female
Gastric cancer
Gastroenterology
Gastroesophageal disorders
Gastroscopy
Hepatology
Humans
Internal Medicine
Lymph node enlargement
Lymph node excision
Lymph nodes
Lymph Nodes - pathology
Lymphatic Metastasis - pathology
Lymphatic system
Male
Medical imaging
Medicine
Medicine & Public Health
Metastasis
Methods
Middle Aged
Patients
Research Article
Review boards
Risk factors
Stomach cancer
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Surgery
Surveillance
Tumors
South Korea
Early gastric cancer
Endoscopic resection
Lymph node enlargement
ISSN:1471-230X, 1471-230X
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Shrnutí:s Background Lymph node (LN) metastasis is negligible in early gastric cancer (EGC) within expanded criteria for endoscopic submucosal dissection (ESD). However, regional lymph nodes in abdominal CT scans are sometimes enlarged in patients with EGC within the expanded criteria for endoscopic submucosal dissection (ESD). In this study, we investigated the clinical significance of regional lymph node enlargement on abdominal CT scan in patients with EGC within the expanded criteria for ESD. Methods From December 2010 to April 2015, among 301 patients with EGC within the ESD expanded criteria, 47 patients with regional lymph node enlargement shown by abdominal CT scan were prospectively enrolled. We performed surgical resection or periodic follow-up with abdominal CT scans and upper endoscopy every 6 months to evaluate whether the enlarged lymph nodes are due to metastasis or a reactive change. Results The mean age of the 47 patients (38 males, 9 female) was 64.8 years. The enlarged lymph nodes were usually single (26/47, 44.6%) and sized as follows: 11 nodes were ≤ 5 mm, 19 were 6–10 mm, and 17 were ≥ 10 mm. Four of the 47 patients initially underwent surgical resection, and 8 patients underwent surgical resection after ESD. However, there was no lymph node metastasis in surgical specimens. Thirty-five patients received ESD and periodically followed up at a median duration of 56 months (IQR: 44–59 month). The enlarged lymph node disappeared in 12 of 35 patients, decreased in 9 patients and remained the same size in 13 patients, and increased in 1 patient. Conclusion Regional lymph node enlargement on abdominal CT scan in patients within expanded criteria for ESD of ECG may be not due to metastasis but a reactive change.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1471-230X
1471-230X
DOI:10.1186/s12876-020-01197-z