Skip to main content
Log in

Lymph node metastasis in early signet ring cell carcinoma: Endoscopic mucosal resection

  • Published:
Chinese Journal of Cancer Research

Abstract

Objective

To identify clinicopathological factors predictive of lymph node metastases (LNM) in early signet ring cell carcinoma (SRC), and further to expand the possibility of using endoscopic mucosal resection (EMR) for the treatment of early SRC.

Methods

Data from 27 surgically treated patients with early SRC were collected, and the association between the clinicopathological factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses.

Results

In the univariate analysis, a tumor larger than 3.0 cm, submucosal invasion, and the presence of lymphatic vessel involvement (LVI) were significantly associated with a higher rate of LNM (all P<0.05). In the multivariate model, the presence of LVI was found of to be an independent pathological risk factor for LNM. There was no LNM in 14 patients without the three clinicopathological risk factors (a tumor larger than 3.0 cm, submucosal invasion, and the presence of LVI).

Conclusion

EMR alone may be sufficient treatment for intramucosal early SRC if the tumor is less than or equal to 3.0 cm in size, and when LVI is absent upon postoperative histological examination. When specimens show LVI, an additional radical gastrectomy with lymphadenectomy should be recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Reference

  1. Makuuchi H, Kise Kise Y, Shimada H, et al. Endoscopic mucosal resection for early gastric cancer[J]. Sem Surg Oncol 1999; 17: 108–116.

    Article  CAS  Google Scholar 

  2. Ishikawa S, Togshi A, Inoue M, et al. Indications for EMR/ESD in cases of early gastric cancer: relationship between histological type, depth of wall invasion, and lymph node metastasis[J]. Gastric Cancer 2007; 10: 35–38.

    Article  PubMed  Google Scholar 

  3. Gotoda T, Yamamoto H, Soetikno RM. Endoscopic submucosal dissection of early gastric cancer[J]. J Gastroenterol 2006; 41: 929–942.

    Article  PubMed  Google Scholar 

  4. Hyung WJ, Cheong JH, Kim J, et al. Application of minimally invasive treatment for early gastric cancer[J]. J Surg Oncol 2004; 85: 181–185.

    Article  PubMed  Google Scholar 

  5. Abe N, Watanabe T, Sugiyama M, et al. Endoscopic treatment or surgery for undifferentiated early gastric cancer[J]? Am J Surg 2004; 188: 181–184.

    Article  PubMed  Google Scholar 

  6. Nasu J, Nishina T, Hirasaki S, et al. Predictive factors of lymph node metastasis in patients with undifferentiated early gastric cancers[J]. J Clin Gastroenterol 2006; 40: 412–415.

    Article  PubMed  Google Scholar 

  7. Japanese Gastric Cancer Association, Japanese classification of gastric carcinoma[M]. 2nd English ed. Gastric Cancer 1998; 1: 10–24.

    Article  PubMed  Google Scholar 

  8. Hyung WJ, Noh SH, Lee JH, et al. Early gastric carcinoma with signet ring cell histology[J]. Cancer 2002; 94: 78–83.

    Article  PubMed  Google Scholar 

  9. Kunisaki C, Shimada H, Nomura M, et al. Therapeutic strategy for signet ring cell carcinoma of the stomach[J]. Br J Surg 2004; 91: 1319–1324.

    Article  PubMed  CAS  Google Scholar 

  10. Ha TK, An JY, Youn HK, et al. Indication for endoscopic mucosal resection in early signet ring cell gastric cancer[J]. Ann Surg Oncol 2007; 15: 508–513.

    Article  PubMed  Google Scholar 

  11. Dong YK, Young KP, Jae KJ, et al. Clinicopathological characteristics of signet ring cell carcinoma of the stomach[J]. ANZ J Surg 2004; 74: 1060–1064.

    Article  Google Scholar 

  12. Gotoda T, Kondo H, Ono H, et al. A new endoscopic mucosal resection procedure using an insulation-tipped electrosurgical knife for rectal lesions: report of two cases[J]. Gastrointest Endosc 1999; 50: 560–563.

    Article  PubMed  CAS  Google Scholar 

  13. Kondo H, Gotoda T, Ono H, et al. early gastric cancer: endoscopic mucosal resection[J]. Ann Ital Chir 2001; 72: 27–31.

    PubMed  CAS  Google Scholar 

  14. Ohkuwa M, Hosokawa K, Boku N, et al. new endoscopic treatment for intramucosal gastric tumors using an insulation-tip diathermic knife[J]. Endoscopy 2001; 33: 221–226.

    Article  PubMed  CAS  Google Scholar 

  15. Miyamoto S, Muto M, Hamamoto Y, et al. a new technique for endoscopic mucosal resection with an insulation-tip electrosurgical knife improves the completeness of resection of intramucosal gastric neoplasms[J]. Gastrointest Endosc 2002; 55: 576–581.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ping Lu  (路平).

Additional information

This work was supported by the Nature Science Foundation of Liaoning Province(No. 20042071).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, H., Lu, P., Zhang, J. et al. Lymph node metastasis in early signet ring cell carcinoma: Endoscopic mucosal resection. Chin. J. Cancer Res. 20, 274–278 (2008). https://doi.org/10.1007/s11670-008-0274-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11670-008-0274-y

Key words

CLC number

Navigation