Influence of Tumor Location on Lymph Node Metastasis and Survival for Early Gastric Cancer: a Population-Based Study

J Gastrointest Surg. 2020 Sep;24(9):1978-1986. doi: 10.1007/s11605-019-04367-x. Epub 2019 Aug 28.

Abstract

Background: The question that whether the criteria for endoscopic resection of early gastric non-cardia cancer (GNCC) is appropriate for early gastric cardia cancer (GCC) remains unclear. Thus, our aim was to evaluate the influence of tumor location on lymph node metastasis (LNM) and overall survival (OS) for early gastric cancer (GC).

Methods: A total of 5440 early GC patients in the Surveillance, Epidemiology, and End Results (SEER) database were identified. Multivariable analysis was performed to evaluate the influence of tumor location on LNM and OS for early GC.

Results: The rate of LNM was 17.48% for early GCC patients (232/1327) and 18.62% for early GNCC patients (766/4113). The early GCC patients experienced no significantly different risk of LNM compared with the early GNCC patients (adjusted OR 0.92, 95% CI 0.76-1.12, P = 0.405). The early GC patients were further stratified by node status. Tumor location was not a predictor of OS for node-negative early GC patients (adjusted HR 1.07, 95% CI 0.96-1.21, P = 0.225) but a predictor of OS for node-positive early GC patients (adjusted HR 1.80, 95% CI 1.48-2.20, P < 0.001).

Conclusions: Tumor location was not a predictor of LNM for early GC patients. Moreover, tumor location was not a predictor of OS for node-negative early GC patients. Thus, the criteria for endoscopic resection of early GNCC might be appropriate for the treatment of early GCC.

Keywords: Gastric cancer; Lymph node metastasis; Overall survival; SEER.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Early Detection of Cancer
  • Gastrectomy
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms* / surgery