Review Article

Lymph Node Metastasis and its Risk Factors for Early Gastritis Individuals Who Underwent Noncurative Endoscopic Resection: A Systematic Review and Meta-Analysis

Abstract

Background: In the present review, we carried out a systematic review and meta-analysis to analyze possible lymph node metastasis (LNM) hazards in individuals with endoscopic resection of gastric cancer.
Methods: Relevant literature was selected by evaluating the PubMed, Cochrane Library, and Google Scholar electronic databases since from inception to March 2022. Corresponding clinicopathological outcomes were summarized, and pooled log odds ratios and 95% confidence intervals were assessed. The random effect model was preferred if variations among studies is high otherwise fixed effect model was preferred.
Results: Overall, 12 associated papers, including 4808 early gastric cancer individuals who endured more surgery after noncurative endoscopic resection, were entered into this analysis. The outcomes showed that submucosal invasion (log odd ratio 1.75, 95% (CI): 0.77–3.95, I2 = 80.0%); vertical margin (log odd ratio 6.53, 95% (CI): 2.81-15.17, I2 = 65%); horizontal margin (log Odd ratio 0.69 95% (CI): 0.22-2.14, I2 = 52%), lymphatic invasion (Odd ratio 6.33 95% (CI): 1.98-20.24, I2 = 91%), and vascular invasion (Odd ratio 3.55, 95% (CI): 1.31-9.58, I2 = 92%) was significantly related to metastasis of lymph node for these patients.
Conclusion: There was a significant association of LNM hazards in individuals with endoscopic resection of gastric cancer. Therefore, invasion to lymph, vascular, submucosa and positive vertical margin should be strongly noticed when selecting surgical treatment factors.

1. Ferlay J, Colombet M, Soerjomataram I, et al (2021). Cancer statistics for the year 2020: An overview. Int J Cancer, doi: 10.1002/ijc.33588.
2. Sasako M (2020). Progress in the treatment of gastric cancer in Japan over the last 50 years. Ann Gastroenterol Surg, 4(1): 21-9.
3. Toya Y, Endo M, Nakamura S, et al (2019). Long-term outcomes and prognostic factors with non-curative endoscopic submucosal dissection for gastric cancer in elderly patients aged≥ 75 years. Gastric Cancer, 22: 838-44.
4. Cao S, Zou T, Sun Q, et al (2020). Safety and long-term outcomes of early gastric cardiac cancer treated with endoscopic submucosal dissection in 499 Chinese patients. Therap Adv Gastroenterol, 13: 1756284820966929.
5. Benites-Goñi H, Palacios-Salas F, Marin-Calderón L, et al (2023). Short-term outcomes of endoscopic submucosal dissection for the treatment of superficial gastric neoplasms in non-Asian countries: a systematic review and meta-analysis. Ann Gastroenterol, 36(2): 167-177.
6. Petruzziello L, Campanale M, Spada C, et al (2018). Endoscopic submucosal dissection of gastric superficial neoplastic lesions: a single Western center experience. United European Gastroenterol J, 6(2): 203-12.
7. Han JP, Hong SJ, Kim HK, et al (2016). Risk stratification and management of non-curative resection after endoscopic submucosal dissection for early gastric cancer. Surg Endosc, 30: 184-9.
8. Choi JY, Jeon SW, Cho KB, et al (2015). Non-curative endoscopic resection does not always lead to grave outcomes in submucosal invasive early gastric cancer. Surg Endosc, 29: 1842-9.
9. Eom BW, Kim YI, Kim KH, et al (2017). Survival benefit of additional surgery after noncurative endoscopic resection in patients with early gastric cancer. Gastrointest Endosc, 85(1): 155-63. e3.
10. Suzuki S, Gotoda T, Hatta W, et al (2017). Survival benefit of additional surgery after non-curative endoscopic submucosal dissection for early gastric cancer: a propensity score matching analysis. Ann Surg Oncol, 24: 3353-60.
11. Chu YN, Yu YN, Jing X, et al (2019). Feasibility of endoscopic treatment and predictors of lymph node metastasis in early gastric cancer. World J Gastroenterol, 25(35): 5344-5355.
12. Ishii S, Yamashita K, Kato H, et al (2016). Predictive factors for lymph node metastasis in additional gastrectomy after endoscopic resection of cT1aN0 gastric cancer. Surg Today, 46: 1031-8.
13. Ito H, Inoue H, Ikeda H, et al (2013). Surgical outcomes and clinicopathological characteristics of patients who underwent potentially noncurative endoscopic resection for gastric cancer: a report of a single-center experience. Gastroenterol Res Pract, 2013: 427405.
14. Kawata N, Kakushima N, Takizawa K, et al (2017). Risk factors for lymph node metastasis and long-term outcomes of patients with early gastric cancer after non-curative endoscopic submucosal dissection. Surg Endosc, 31: 1607-16.
15. Kikuchi S, Kuroda S, Nishizaki M, et al (2017). Management of early gastric cancer that meet the indication for radical lymph node dissection following endoscopic resection: a retrospective cohort analysis. BMC Surg,17: 72.
16. Kim E, Lee H, Min BH, et al (2015). Effect of rescue surgery after non-curative endoscopic resection of early gastric cancer. Br J Surg, 102(11): 1394-401.
17. Liang XQ, Wang Z, Li H-, et al (2020). Indication for endoscopic treatment based on the risk of lymph node metastasis in patients with undifferentiated early gastric cancer. Asian J Surg, 43(10): 973-7.
18. Ren MH, Qi XS, Chu YN, et al (2021).Risk of lymph node metastasis and feasibility of endoscopic treatment in ulcerative early gastric cancer. Ann Surg Oncol, 28: 2407-17.
19. Sunagawa H, Kinoshita T, Kaito A, et al (2017).Additional surgery for non-curative resection after endoscopic submucosal dissection for gastric cancer: a retrospective analysis of 200 cases. Surg Today, 47: 202-9.
20. Suzuki H, Oda I, Abe S, et al (2017). Clinical outcomes of early gastric cancer patients after noncurative endoscopic submucosal dissection in a large consecutive patient series. Gastric Cancer, 20: 679-89.
21. Toyokawa T, Ohira M, Tanaka H, et al (2016). Optimal management for patients not meeting the inclusion criteria after endoscopic submucosal dissection for gastric cancer. Surg Endosc, 30: 2404-14.
22. Yang HJ, Jang JY, Kim SG, et al (2021). Risk factors of lymph node metastasis after non-curative endoscopic resection of undifferentiated-type early gastric cancer. Gastric Cancer, 24: 168-78.
23. Noh GY, Ku HR, Kim YJ, et al (2015). Clinical outcomes of early gastric cancer with lymphovascular invasion or positive vertical resection margin after endoscopic submucosal dissection. Surg Endosc, 29: 2583-9.
24. Toya Y, Endo M, Nakamura S, et al (2017). Clinical outcomes of non-curative endoscopic submucosal dissection with negative resected margins for gastric cancer. Gastrointest Endosc, 85(6): 1218-24.
25. Yamanouchi K, Ogata S, Sakata Y, et al (2016). Effect of additional surgery after noncurative endoscopic submucosal dissection for early gastric cancer. Endosc Int Open, 4(01): E24-E9.
26. Hatta W, Gotoda T, Oyama T, et al (2017). Is radical surgery necessary in all patients who do not meet the curative criteria for endoscopic submucosal dissection in early gastric cancer? A multi-center retrospective study in Japan. J Gastroenterol, 52: 175-84.
27. Son SY, Park JY, Ryu KW, et al (2013). The risk factors for lymph node metastasis in early gastric cancer patients who underwent endoscopic resection: is the minimal lymph node dissection applicable? A retrospective study. Surg Endosc, 27: 3247-53.
28. Yang HJ, Kim SG, Lim JH, et al (2015). Predictors of lymph node metastasis in patients with non-curative endoscopic resection of early gastric cancer. Surg Endosc, 29: 1145-55.
29. Stang A (2010). Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 25: 603-5.
30. Oda I, Oyama T, Abe S, et al (2014). Preliminary results of multicenter questionnaire study on long‐term outcomes of curative endoscopic submucosal dissection for early gastric cancer. Dig Endosc, 26(2): 214-9.
31. Park CH, Shin S, Park JC, et al (2013). Long-term outcome of early gastric cancer after endoscopic submucosal dissection: expanded indication is comparable to absolute indication. Dig Liver Dis, 45(8): 651-6.
32. Suzuki H, Oda I, Abe S, et al (2016). High rate of 5-year survival among patients with early gastric cancer undergoing curative endoscopic submucosal dissection. Gastric cancer, 19: 198-205.
33. Jiao X, Wang Y, Wang F, Wang X (2020).Recurrence pattern and its predictors for advanced gastric cancer after total gastrectomy. Medicine (Baltimore), 99(51): e23795.
34. Jeon MY, Park JC, Hahn KY, Shin SK, Lee SK, Lee YC (2018). Long-term outcomes after noncurative endoscopic resection of early gastric cancer: the optimal time for additional endoscopic treatment. Gastrointest Endosc, 87(4): 1003-13. e2.
35. Jung DH, Lee YC, Kim JH, et al (2017). Additive treatment improves survival in elderly patients after non-curative endoscopic resection for early gastric cancer. Surg Endosc, 31: 1376-82.
36. Kim H, Kim JH, Park JC, Lee YC, Noh SH, Kim H (2011). Lymphovascular invasion is an important predictor of lymph node metastasis in endoscopically resected early gastric cancers. Oncol Rep, 25(6): 1589-95.
37. Kumar A (2023). Meta-analysis in Clinical Research: Principles and Procedures. Springer Nature. ISBN; 978-981-99-2369-4.
38. Singh RK (2023). A meta-analysis of the impact on gastrectomy versus endoscopic submucosal dissection for early stomach cancer. IJCMR, 1(3): 88-99. doi: 10.61466/ijcmr1030011.
39. Thakur M, Babu A, Khatik GL, Datusalia AK, Khatri R, Kumar A (2023). Role of baricitinib in COVID-19 patients: A systematic review and meta-analysis. World J Meta-Anal, 11(4): 125-33.
40. Alam N, Latha S, Kumar A (2023). Safety and efficacy of monoclonal antibodies targeting IL-5 in severe eosinophilic asthma: A Systematic review and meta-analysis of randomized controlled trials. Health Sci Rev, 8: 100103.
41. Thakur M, Datusalia AK, Kumar A (2022). Use of steroids in COVID-19 patients: A meta-analysis. Eur J Pharmacol, 914: 174579.
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IssueVol 53 No 10 (2024) QRcode
SectionReview Article(s)
DOI https://doi.org/10.18502/ijph.v53i10.16697
Keywords
Noncurative endoscopic resection Early gastric cancer Endoscopic dissection

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How to Cite
1.
Xu N, Zhang Y, Ma X, Meng W. Lymph Node Metastasis and its Risk Factors for Early Gastritis Individuals Who Underwent Noncurative Endoscopic Resection: A Systematic Review and Meta-Analysis. Iran J Public Health. 2024;53(10):2191-2200.