title: Tumor differentiation is not a risk factor for lymph node metastasis in elderly patients with early gastric cancer.
abstract: BACKGROUND
  The aim of this study was to identify risk factors for lymph node metastasis in elderly patients (70 years or more) with early gastric cancer.
  
  
  METHODS
  We reviewed the prospectively collected database of 6893 patients with early gastric cancer who had undergone curative gastrectomy in 3 tertiary cancer centers between January 2003 and December 2009 in Korea. Patients were sorted into 4 groups according to age: less than 50, fifties, sixties, and 70 years or more. Risk factors for lymph node metastasis in early gastric cancer were analyzed.
  
  
  RESULTS
  One thousand and thirty five patients (15.0%) were 70 years or more. As age increased, the frequency of large differentiated tumor, lymphatic and submucosa invasion increased. Old age was associated with a lower risk for lymph node metastasis in patients with early gastric cancer (Odds ratio [OR], OR, 0.622; 95% CI, 0.5466-0.830, P = 0.010). Ulceration or differentiation of tumor was not associated with lymph node metastasis in elderly patients with early gastric cancer.
  
  
  CONCLUSIONS
  Elderly patients with undifferentiated type histology early gastric cancer without other risk factors for lymph node metastasis may be candidates for endoscopic resection.
authors.affiliation: Department of Surgery, Sungkyunkwan University School of Medicine, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Center for Clinical Trial, National Cancer Center, South Korea.
authors.forename: B-H
authors.initials: BH
authors.lastname: Nam
authors.affiliation: Center for Gastric Cancer, National Cancer Center, South Korea.
authors.forename: K W
authors.initials: KW
authors.lastname: Ryu
authors.affiliation: Department of Surgery, Chonnam National University Hwasoon Hospital, South Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Ryu
authors.affiliation: Center for Gastric Cancer, National Cancer Center, South Korea.
authors.forename: Y W
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Department of Surgery, Sungkyunkwan University School of Medicine, South Korea.
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Surgery, Chonnam National University Hwasoon Hospital, South Korea. Electronic address: parkyk@jnu.ac.kr.
authors.forename: Y K
authors.initials: YK
authors.lastname: Park
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002454:Cell Differentiation; D016208:Databases, Factual; D005260:Female; D005743:Gastrectomy / Q000379:methods; D005773:Gastroscopy; D006801:Humans; D010535:Laparoscopy; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D013276:Stomach Ulcer / Q000150:complications*
keywords: Elderly; Endoscopic procedure; Gastric cancer