"Early Gastric Cancer, Predicting Lymph Node Metastasis Risk in Advance to Reduce Gastrectomy"

Seoul Asan Hospital Professors An Ji-yong, Noh Jin-hee, and Lee In-seop Team
Developed a Scale to Calculate Lymph Node Metastasis Probability by Analyzing 1000 Patients

Professor An Ji-yong of the Department of Gastroenterology at Asan Medical Center in Seoul is treating an early gastric cancer patient with an upper endoscopy procedure.

[Asia Economy Reporter Lee Gwan-joo] A study has been published showing that it is possible to predict the likelihood of lymph node metastasis before early gastric cancer surgery.

The research team led by Professors An Ji-yong and Noh Jin-hee from the Department of Gastroenterology and Professor Lee In-seop from the Department of Gastrointestinal Surgery at Seoul Asan Medical Center analyzed over 1,000 patients who underwent total gastrectomy for early gastric cancer located in the upper stomach and developed a scale to predict the possibility of lymph node metastasis based on cancer progression status, announced on the 30th.

When early gastric cancer occurs in the upper stomach, it is first determined whether endoscopic treatment is possible. If the cancer has deeply invaded and cannot be treated by endoscopy, total gastrectomy is performed due to the risk of recurrence. At this time, post-gastrectomy syndrome, which inevitably causes dumping syndrome, anemia, nutrient deficiency, and weight loss, can significantly reduce quality of life.

However, with the early gastric cancer lymph node metastasis prediction scale developed by the research team, it is now possible to attempt endoscopic treatment first as much as possible, and even if surgery is required because it is difficult to remove the cancer endoscopically, localized stomach-preserving surgery that removes only the cancerous part can be more easily considered.

The research team analyzed 1,025 patients who underwent total gastrectomy for early gastric cancer in the upper stomach from January 2001 to December 2017. Among them, 925 patients (about 90.2%) had no lymph node metastasis, while 100 patients (about 9.8%) had cancer metastasis to lymph nodes. There was no difference in family history between the two groups.

Through statistical analysis, the team created the early gastric cancer lymph node metastasis prediction scale based on tumor size and depth, and whether lymphovascular and neural invasion connected to lymph nodes was present. Tumor size was classified based on 2 cm, and depth was divided according to whether the cancer invaded the mucosal layer or the upper submucosal layer, or deeper, dividing early gastric cancer into a total of 16 cases. Statistical evaluation of the scale’s validity showed an accuracy of 83%.

Professor An Ji-yong said, “Because various factors influence which treatment is effective depending on the likelihood of lymph node metastasis in each case, a standard treatment guideline has not been established, but in the future, cases where endoscopic treatment is considered first by comprehensively considering the patient’s age and overall health status will increase.”

Professor Lee In-seop said, “The age group with the highest incidence of gastric cancer is in their 60s, and as Korean society is approaching a super-aged era with an increasing number of patients with underlying diseases, even for early gastric cancer requiring surgery, we will consider the patient’s quality of life as much as possible by using the metastasis prediction scale to perform stomach-preserving surgery and other treatments.”

This research was recently published in the Journal of the Korean Gastric Cancer Association.

This content was produced with the assistance of AI translation services.