PROGNOSTICATION OF THE RISK OF ERG’S LYMPH NODE METASTASIS FOR PATIENTS WITH EARLY GASTRIC CANCER, WHICH GOES BEYOND EXPANDED INDICATIONS FOR ENDOSCOPIC RESECTION

Abstract

Additional surgical operation with lymph dissection is necessary after early gastric cancer’s (ERG) endoscopic resection (ER) and if tumor’s characteristics exceed certain JGCA [1] extended ER indications. However, during the research of surgical material from patients, who have undergone not radical ER, regional lymphogenic metastatic spreading is detected in small number of cases [2, 3, 4, 5]. Considering the low risk of lymph node metastasis and this patients group’s survivability, the issue of additional surgical operation’s importance is still questionable. In our research, we formed a rule for determining a tactic to treat ERG with expanded indications. The research consisted of two stages. During the first stage, we selected 229 patients with expanded indications from a total group with ERG (404 patients). Considering the low mortality risk from progressing ERG (14,4%, 33/229) during 10 years of observation (observation time median = 132 months), and using multi-dimensional logical analysis, we developed a regression equation to measure the risk of ERG’s lymph node metastasis amongst this category of patients. During the second stage, we divided 229 patients into 2 groups - with low and high risk of ERG’s lymph node metastasis - using the regression equation. The level of metastasis correlates with indications of tumor-specific survivability and survivability without indications of progression. The frequency of correct predictions is 83, %.