Predictive Factors for Lymph Node Metastasis in Undifferentiated Early Gastric Cancer a Systematic Review and Meta-analysis 未分化早期胃癌淋巴结转移预测因素的系统评价及meta分析.pdfVIP

J Gastrointest Surg DOI 10.1007/s11605-017-3364-7 REVIEW ARTICLE Predictive Factors for Lymph Node Metastasis in Undifferentiated Early Gastric Cancer: a Systematic Review and Meta-analysis Xudong Zhao 1 Aizhen Cai 1 Hongqing Xi 1 Lin Chen 1 Zheng Peng 1 Peiyu Li 1 Na Liu 1 Jianxin Cui 1 Hua Li 1,2 Received: 7 October 2016 /Accepted: 4 January 2017 # 2017 The Society for Surgery of the Alimentary Tract Abstract Objectives Less invasive surgery is gaining popularity for the treatment of early gastric cancer (EGC), but there are no definitive guidelines for the use of less invasive surgery for the treatment of undifferentiated EGC. The aims of this meta-analysis were to identify potential predictive factors for lymph node metastasis (LNM) in undifferentiated EGC and to guide the personalized therapeutic modality for patients with undifferentiated EGC. Methods An extensive search of the PubMed, Embase, and Cochrane Library databases was performed to identify relevant articles involving undifferentiated EGC and LNM. Eligible data were systematically reviewed through a meta-analysis using Review Manager 5.3. Results In total, 23 studies were included in this analysis. The meta-analysis found that the variables sex (female), age (greater than 60 years), tumor size (greater than 20 mm), depth of invasion (submucosal invasion), presence of lymphovascular involve- ment, presence of ulcer findings, histology type (non-signet ring carcinoma), and tumor location (not in the middle part of the stomach) were significantly associated with LNM. Conclusions Eight variables were identified as predictive factors for LNM in undifferentiated EGC. The significance of these variables should be further confirmed during the process of LNM in undifferentiated EGC patients for future clinical application. Keyword