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Influence of Tumor Location on Lymph Node Metastasis and Survival for Early Gastric Cancer: a Population-Based Study

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

The question that whether the criteria for endoscopic resection of early gastric non-cardia cancer (GNCC) is appropriate for early gastric cardia cancer (GCC) remains unclear. Thus, our aim was to evaluate the influence of tumor location on lymph node metastasis (LNM) and overall survival (OS) for early gastric cancer (GC).

Methods

A total of 5440 early GC patients in the Surveillance, Epidemiology, and End Results (SEER) database were identified. Multivariable analysis was performed to evaluate the influence of tumor location on LNM and OS for early GC.

Results

The rate of LNM was 17.48% for early GCC patients (232/1327) and 18.62% for early GNCC patients (766/4113). The early GCC patients experienced no significantly different risk of LNM compared with the early GNCC patients (adjusted OR 0.92, 95% CI 0.76–1.12, P = 0.405). The early GC patients were further stratified by node status. Tumor location was not a predictor of OS for node-negative early GC patients (adjusted HR 1.07, 95% CI 0.96–1.21, P = 0.225) but a predictor of OS for node-positive early GC patients (adjusted HR 1.80, 95% CI 1.48–2.20, P < 0.001).

Conclusions

Tumor location was not a predictor of LNM for early GC patients. Moreover, tumor location was not a predictor of OS for node-negative early GC patients. Thus, the criteria for endoscopic resection of early GNCC might be appropriate for the treatment of early GCC.

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Funding

This project is supported by Hainan Provincial Natural Science Foundation of China (819QN375, 2017CXTD0012) and Hainan Provincial Key R&D Program (ZDYF2018101).

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Author notes

  1. Yang ZeLong and Chang ZhenYu contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Chinese People’s Liberation Army General Hospital, Beijing, China

    Yang ZeLong, Chang ZhenYu, Zhu MingHua, Zhang KeCheng & Wang ChunXi

  2. Department of General Surgery, Hainan Branch of Chinese People’s Liberation Army General Hospital, Beijing, China

    Yang ZeLong & Wang ChunXi

  3. Department of General Surgery, The Fifth Medical Center of PLA General Hospital, Beijing, China

    Long JianHai

Authors
  1. Yang ZeLong
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  2. Chang ZhenYu
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  3. Long JianHai
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  4. Zhu MingHua
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  5. Zhang KeCheng
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Contributions

Study conception and design: Z.L.Y., Z.Y. C., C.X.W., Z.K.C., and J.H.L.. Acquisition of data: Z.L.Y., Z.Y. C., C.X.W., Z.K.C., and J.H.L.. Analysis and interpretation of data: all authors. Drafting of manuscript: all authors. Critical revision: all authors.

Corresponding authors

Correspondence to Zhang KeCheng or Wang ChunXi.

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Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All the patients in this study were included from the SEER database, and we have got the permission of using the data.

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ZeLong, Y., ZhenYu, C., JianHai, L. et al. Influence of Tumor Location on Lymph Node Metastasis and Survival for Early Gastric Cancer: a Population-Based Study. J Gastrointest Surg 24, 1978–1986 (2020). https://doi.org/10.1007/s11605-019-04367-x

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  • DOI: https://doi.org/10.1007/s11605-019-04367-x

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