Analysis Of Risk Factors For Lymph Node Metastasis In Early Gastric Cancer And The Necessity Of Additional Surgery After Endoscopic Non-curative Resection From Single-center Data

Objective:for the past few years,a large number of studies domesic and overeas revealed that Less invasive surgery such as endoscopic resection are suitable for the treatment of patients with early gastric cancer.Endoscopic resection is more widely used in the treatment of patients with early gastric cancer.However,for patients with a higher risk of lymph node metastasis,curative resection cannot be performed by endoscopic surgery alone..How to treat the patients after endoscopic non-cure resection is still controversial.This study aims to analyze the risk factors of lymph node metastasis in early gastric cancer,which is based on endoscopic non-cure Patients after surgical resection choose the appropriate follow-up diagnosis and treatment programs.Methods:In this study,1,318 patients who underwent radical gastric cancer surgery at the First Affiliated Hospital of Nanchang University from January 2010 to October 2018 were selected.Of these,21 patients were patients after endoscopic non-cure resection.We analyzed the relationship between clinicopathological data and lymph node metastasis Results:Among 1,318 EGC patients,the overall lymph node metastasis rate was 16.23%,intramucosal cancer was 9.71%,submucosal cancer was 22.79%.Univariate analysis showed that the location,size,depth of invasion,gross type,histological type,and vascular invasion had significant effects on LNM;multivariate analysis revealed that submucosal infiltration,undifferentiated tumors,and vascular invasion were lymph node metastases Independent risk factors;of the 21 patients who underwent endoscopic resection,2 had lymph node metastasis;and 3 had residual primary tumor.The analysis showed that vascular invasion was a risk factor for lymph nodemetastasis,and the difference was statistically significant;the depth of invasion PT1b2 and the positive horizontal resection margin were risk factors for tumor residual,and the difference was statistically significant Conclusion:Patients with submucosal tumors and vascular invasion are more likely to be seen with lymph node metastasis,and we must be more careful when choosing the appropriate treatment.In patients with endoscopic resection,patients with vascular metastasis,infiltration depth up to PT1b2,and patients with positive vertical resection margins should undergo additional surgery;if the horizontal resection margin is the only risk factor,endoscopic resection may be considered...