Lymph Node Metastasis in Early Signet Ring Cell Carcinoma: Feasibility of Endoscopic Mucosal Resection (17 Apr 2008) 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 patients with early SRC and surgically treated 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 to be independently risk pathological factor for LNM. There was no LNM in 14 patients without the three risk clinicopathological factors (a tumor larger than 3.0 cm, submucosal invasion, and the presence of LVI).
Conclusions: 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 shows with LVI, an additional radical gastrectomy with lymphadenectomy should be recommended.
Key words: Early signet ring cell carcinoma; LNM; Clinicopathological characteristics; Endoscopic mucosal resection
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