Tumor differentiation is not a risk factor for lymph node metastasis in elderly patients with early gastric cancer

Eur J Surg Oncol. 2014 Dec;40(12):1771-6. doi: 10.1016/j.ejso.2014.07.042. Epub 2014 Aug 23.

Abstract

Background: The aim of this study was to identify risk factors for lymph node metastasis in elderly patients (70 years or more) with early gastric cancer.

Methods: We reviewed the prospectively collected database of 6893 patients with early gastric cancer who had undergone curative gastrectomy in 3 tertiary cancer centers between January 2003 and December 2009 in Korea. Patients were sorted into 4 groups according to age: less than 50, fifties, sixties, and 70 years or more. Risk factors for lymph node metastasis in early gastric cancer were analyzed.

Results: One thousand and thirty five patients (15.0%) were 70 years or more. As age increased, the frequency of large differentiated tumor, lymphatic and submucosa invasion increased. Old age was associated with a lower risk for lymph node metastasis in patients with early gastric cancer (Odds ratio [OR], OR, 0.622; 95% CI, 0.5466-0.830, P = 0.010). Ulceration or differentiation of tumor was not associated with lymph node metastasis in elderly patients with early gastric cancer.

Conclusions: Elderly patients with undifferentiated type histology early gastric cancer without other risk factors for lymph node metastasis may be candidates for endoscopic resection.

Keywords: Elderly; Endoscopic procedure; Gastric cancer.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cell Differentiation
  • Databases, Factual
  • Female
  • Gastrectomy* / methods
  • Gastroscopy
  • Humans
  • Laparoscopy
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Odds Ratio
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery*
  • Stomach Ulcer / complications*