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Journal of Gastrointestinal Surgery

, Volume 21, Issue 4, pp 700–711 | Cite as

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

  • Xudong Zhao
  • Aizhen Cai
  • Hongqing Xi
  • Lin ChenEmail author
  • Zheng PengEmail author
  • Peiyu Li
  • Na Liu
  • Jianxin Cui
  • Hua Li
Review Article

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.

Keywords

Undifferentiated early gastric cancer Meta-analysis Lymph node metastasis 

Notes

Author Contributions

Xudong Zhao, Aizhen Cai, and Hongqing Xi conceived and designed the study and wrote the manuscript. Peiyu Li, Jianxin Cui, Na Liu, and Hua Li collected the data, performed the meta-analysis, and interpreted the outcome. Lin Chen and Zheng Peng critically reviewed the content of the manuscript and helped with drafts.

Compliance with Ethical Standards

Grant Support

None.

Supplementary material

11605_2017_3364_Fig11_ESM.gif (122 kb)
Supplemental Figure 1

The funnel plot for LNM and sex (GIF 121 kb)

11605_2017_3364_MOESM1_ESM.tif (1.4 mb)
High Resolution image (TIF 1452 kb)
11605_2017_3364_Fig12_ESM.gif (110 kb)
Supplemental Figure 2

The funnel plot for LNM and size (GIF 110 kb)

11605_2017_3364_MOESM2_ESM.tif (1.4 mb)
High Resolution image (TIF 1457 kb)
11605_2017_3364_Fig13_ESM.gif (127 kb)
Supplemental Figure 3

The funnel plot for LNM and depth of invasion (GIF 127 kb)

11605_2017_3364_MOESM3_ESM.tif (1.4 mb)
High Resolution image (TIF 1449 kb)
11605_2017_3364_Fig14_ESM.gif (119 kb)
Supplemental Figure 4

The funnel plot for LNM and lymphovascular involvement (GIF 118 kb)

11605_2017_3364_MOESM4_ESM.tif (1.4 mb)
High Resolution image (TIF 1483 kb)
11605_2017_3364_Fig15_ESM.gif (117 kb)
Supplemental Figure 5

The funnel plot for LNM and ulcer findings (GIF 117 kb)

11605_2017_3364_MOESM5_ESM.tif (1.5 mb)
High Resolution image (TIF 1494 kb)
11605_2017_3364_Fig16_ESM.gif (121 kb)
Supplemental Figure 6

The funnel plot for LNM and histology type (GIF 120 kb)

11605_2017_3364_MOESM6_ESM.tif (1.5 mb)
High Resolution image (TIF 1495 kb)
11605_2017_3364_Fig17_ESM.gif (126 kb)
Supplemental Figure 7

The funnel plot for LNM and location (GIF 125 kb)

11605_2017_3364_MOESM7_ESM.tif (1.5 mb)
High Resolution image (TIF 1493 kb)
11605_2017_3364_Fig18_ESM.gif (115 kb)
Supplemental Figure 8

The funnel plot for LNM and age (GIF 114 kb)

11605_2017_3364_MOESM8_ESM.tif (1.4 mb)
High Resolution image (TIF 1470 kb)
11605_2017_3364_Fig19_ESM.gif (121 kb)
Supplemental Figure 9

The funnel plot for LNM and macroscopic type (GIF 120 kb)

11605_2017_3364_MOESM9_ESM.tif (1.4 mb)
High Resolution image (TIF 1470 kb)

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Copyright information

© The Society for Surgery of the Alimentary Tract 2017

Authors and Affiliations

  1. 1.Department of General SurgeryChinese People’s Liberation Army General HospitalBeijingChina
  2. 2.Department of Surgical OncologyAffiliated Xing Tai People Hospital of Hebei Medial UniversityXingtaiChina

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