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Young Age and Risk of Lymph Node Metastasis in Differentiated Type Early Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Young patients with gastric cancer reportedly have a worse prognosis than older patients due to delayed diagnosis and more aggressive tumor behavior. However, it is unclear whether this applies to early gastric cancer (EGC), for which endoscopic resection is indicated. We investigated the association between age and lymph node metastasis (LNM).

Methods

We identified 4055 patients diagnosed with EGC of differentiated histology who underwent surgery. The association between age and LNM was examined using logistic regression for each T stage separately with adjustments for multiple covariates. We compared LNM rates for each of the Japanese Endoscopic Resection Guidelines criteria in younger (< 40 years) and older patients (40 years).

Results

The median number of lymph nodes examined was the same for T1a and T1b stages (n = 34). The median number of lymph nodes examined was not significantly different within T1a stage (P = 0.093), but within T1b stage, the number of lymph nodes examined was significantly different (P = 0.019). The highest number was between 50 and 59 years (median = 37), and the lowest number was in the 20 to 49 years and older than 70 age brackets (median = 34). LNM rate and age were not significantly associated within each stage (P values 0.269, 0.783 for T1a and T1b, respectively). Among patients fulfilling endoscopic resection criteria, the LNM rate in younger patients was lower than in older patients.

Conclusions

In differentiated-type EGC, young age at diagnosis was not associated with LNM rate. Therefore, endoscopic resection criteria for early gastric cancer can be applied to younger patients.

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Authors and Affiliations

  1. Center for Health Promotion, Samsung Medical Center, Seoul, Republic of Korea

    Jeung Hui Pyo MD & Yoon-Ho Choi MD, PhD

  2. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Hyuk Lee MD, PhD, Yang Won Min MD, PhD, Byung-Hoon Min MD, PhD, Jun Haeng Lee MD, PhD & Jae J. Kim MD, PhD

  3. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Kyoung-Mee Kim MD, PhD

  4. Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea

    Heejin Yoo MS & Kyunga Kim PhD

  5. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Sung Kim MD, PhD

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  1. Jeung Hui Pyo MD
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  2. Hyuk Lee MD, PhD
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  4. Byung-Hoon Min MD, PhD
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Corresponding author

Correspondence to Hyuk Lee MD, PhD.

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Disclosure

No external sources of funding were received for this study. All authors declare no conflicts of interest.

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Supplementary material 1 (DOCX 19 kb)

Supplementary Fig. 1

Survival curves: a) overall survival; b) recurrence-free survival; c) overall survival; d) recurrence-free survival in younger (≤ 40 years) vs. older patients (> 40 years) (TIFF 1366 kb)

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Pyo, J.H., Lee, H., Min, Y.W. et al. Young Age and Risk of Lymph Node Metastasis in Differentiated Type Early Gastric Cancer. Ann Surg Oncol 25, 2713–2719 (2018). https://doi.org/10.1245/s10434-018-6659-3

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  • DOI: https://doi.org/10.1245/s10434-018-6659-3

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