A new diagnostic method for early gastric cancer: volume measurement by 3-dimensional endoscopic ultrasonography in early gastric cancer and its clinical significance.

BACKGROUND The objective of the present study was to measure the volume of early gastric cancer using 3-dimensional endoscopic ultrasonography (3D-EUS) and to ascertain the clinical significance of this new diagnostic method. PATIENTS AND METHODS The study comprised 100 patients with early gastric cancer who underwent preoperative 3D-EUS followed by surgical resection. The relationships of lymph node metastasis to 10 clinicopathological factors (gender, age, tumor location, ulcer, depth, macroscopic type, tumor histology, lymphatic invasion and venous invasion) and preoperative tumor volume (log tumor volume) as measured by 3D-EUS were determined. RESULTS Median tumor volume was 414.75 mm3 (range, 7.8-2,683.8 mm3) and median log tumor volume was 2.617 (range, 1.444-3.429). Univariate analyses showed that three factors (lymphatic invasion, p=0.0001; venous invasion, p=0.0216; log tumor volume, p=0.0121) correlated significantly with lymph node metastasis. Multivariate analysis showed only two factors (lymphatic invasion, p=0.011, regression coefficient=0.104; log tumor volume, p=0.020, regression coefficient=30.414) representing independent predictors for lymph node metastasis. CONCLUSION Tumor volume as measured by 3D-EUS represents an independent risk factor for lymph node metastasis in early gastric cancer. This new method can be used as a reliable diagnostic tool for early gastric cancer.

[1]  Y. Seto,et al.  Impact of lymph node metastasis on survival with early gastric cancer , 1997, World Journal of Surgery.

[2]  Xin-Gang Shi,et al.  Endoscopic submucosal dissection for early gastric cancers , 2008 .

[3]  P. Lin,et al.  Endoscopic Submucosal Dissection for Early Gastric Cancers: Experience From a New Endoscopic Center in Taiwan , 2008, Journal of clinical gastroenterology.

[4]  Laura H. Tang,et al.  Clinical Correlation of Endoscopic Ultrasonography with Pathologic Stage and Outcome in Patients Undergoing Curative Resection for Gastric Cancer , 2007, Annals of Surgical Oncology.

[5]  S. Ishikawa,et al.  Indications for EMR/ESD in cases of early gastric cancer: relationship between histological type, depth of wall invasion, and lymph node metastasis , 2007, Gastric Cancer.

[6]  S. Lo,et al.  Surgical Results of Early Gastric Cancer and Proposing a Treatment Strategy , 2007, Annals of Surgical Oncology.

[7]  Shinji Tanaka,et al.  Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. , 2006, Gastrointestinal endoscopy.

[8]  Masahiko Watanabe,et al.  Pre-operative tumor assessment of patients with gastric cancer based on virtual endoscopy using multidetector-row computer tomography. , 2006, Anticancer research.

[9]  J. Gaughan,et al.  Three-dimensional US volume analysis of gastric pseudotumors in a porcine model. , 2006, Gastrointestinal endoscopy.

[10]  M. Mizuguchi,et al.  Clinical outcomes of EMR for gastric tumors: historical pilot evaluation between endoscopic submucosal dissection and conventional mucosal resection. , 2006, Gastrointestinal endoscopy.

[11]  Tomohiro Nishina,et al.  Predictive Factors of Lymph Node Metastasis in Patients With Undifferentiated Early Gastric Cancers , 2006, Journal of clinical gastroenterology.

[12]  Tumur Tsendsuren,et al.  Usefulness of endoscopic ultrasonography in preoperative TNM staging of gastric cancer. , 2006, World journal of gastroenterology.

[13]  Kiyonori Kobayashi,et al.  New diagnostic imaging of gastointestinal tumors: a preliminary study of three-dimensional tumor structure and volumetry. , 2005, Anticancer research.

[14]  S. Kitano,et al.  Minimally invasive surgery for gastric tumors. , 2005, The Surgical clinics of North America.

[15]  渡邉 摩也.  Measuring tumor volume with three-dimensional endoscopic ultrasonography : an experimental and clinical study , 2005 .

[16]  Introduction to JGCA gastric cancer treatment guidelines , 2005 .

[17]  N. Katada,et al.  Laparoscopy-assisted distal gastrectomy for early gastric cancer , 2005, Surgical Endoscopy And Other Interventional Techniques.

[18]  M. Watanabe,et al.  Measuring Tumor Volume with Three-Dimensional Endoscopic Ultrasonography: an Experimental and Clinical Study (including video) , 2004, Endoscopy.

[19]  Y. J. Kim,et al.  Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma. , 2004, World journal of gastroenterology.

[20]  Masahiko Watanabe,et al.  Survival after surgical treatment of early gastric cancer: surgical techniques and long-term survival , 2004, Langenbeck's Archives of Surgery.

[21]  Y. Shimada.  JGCA (The Japan Gastric Cancer Association). Gastric cancer treatment guidelines. , 2004, Japanese journal of clinical oncology.

[22]  K. Mafune,et al.  Concepts, Rationale, and Current Outcomes of Less Invasive Surgical Strategies for Early Gastric Cancer: Data from a quarter-century of experience in a single institution , 2004, World Journal of Surgery.

[23]  G. Ren,et al.  Endoscopic ultrasonography in preoperative staging of gastric cancer: determination of tumor invasion depth, nodal involvement and surgical resectability. , 2003, World journal of gastroenterology.

[24]  A. Kakita,et al.  Evaluation of the morphology of submucosal tumor invasion and its volume in early gastric cancer. , 2003, In vivo.

[25]  H. Mitomi,et al.  Clinical outcome of endoscopic aspiration mucosectomy for early stage gastric cancer. , 2002, Gastrointestinal endoscopy.

[26]  M. Sierzega,et al.  Long‐term results of surgery for early gastric cancer , 2002, The British journal of surgery.

[27]  O. Nanni,et al.  Risk factors for lymph node metastases and their prognostic significance in early gastric cancer (EGC) for the Italian Research Group for Gastric Cancer (IRGGC). , 2001, Japanese journal of clinical oncology.

[28]  A. Kakita,et al.  A new staging system based on tumor volume in gastric cancer. , 2001, Anticancer research.

[29]  A. Fingerhut,et al.  Lymphatic involvement in early gastric cancer: prevalence and prognosis in France. , 2000, Archives of surgery.

[30]  A. Kakita,et al.  Surgical outcome of node-positive early gastric cancer with particular reference to nodal status. , 2000, Anticancer research.

[31]  A. Kakita,et al.  Tumor volumetry: proposal of a new concept to predict lymph node metastasis in early gastric cancer. , 2000, Anticancer research.

[32]  Shiro Kikuchi,et al.  Measuring the Tumor Volume of Gastric Carcinoma by Computer Image Analysis: Clinical Significance , 2000, World Journal of Surgery.

[33]  S. Kikuchi,et al.  Tumor volume: a novel prognostic factor in patients who undergo curative resection for gastric cancer , 2000, Langenbeck's Archives of Surgery.

[34]  H. Goto,et al.  The utility of endoscopic ultrasonography and endoscopy in the endoscopic mucosal resection of early gastric cancer , 1999, Gut.

[35]  Japanese Gastric Cancer Association.  Japanese Classification of Gastric Carcinoma – 2nd English Edition – , 1998, Gastric Cancer.

[36]  H. Taniguchi,et al.  Analysis of lymph node metastasis in early gastric cancer: Rationale of limited surgery , 1997, Journal of surgical oncology.

[37]  S. Yoshida,et al.  Risk factors for lymph node metastasis from intramucosal gastric carcinoma , 1996, Cancer.