title: Predictive Factors for Lymph Node Metastasis in Undifferentiated Early Gastric Cancer: a Systematic Review and Meta-analysis.
abstract: 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.
  
  
  
  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.
  
  
  
  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 involvement, 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.
  
  
  
  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.
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors.forename: Xudong
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors.forename: Aizhen
authors.initials: A
authors.lastname: Cai
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors.forename: Hongqing
authors.initials: H
authors.lastname: Xi
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China. chenlin0395@126.com.
authors.forename: Lin
authors.identifier: 0000-0003-2354-3182
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China. pengzheng301@sina.com.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Peng
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors.forename: Peiyu
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors.forename: Na
authors.initials: N
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors.forename: Jianxin
authors.initials: J
authors.lastname: Cui
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.|Department of Surgical Oncology, Affiliated Xing Tai People Hospital of Hebei Medial University, Xingtai, 054001, Hebei Province, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Li
mesh_terms: D000367:Age Factors; D006801:Humans; D008207:Lymphatic Metastasis; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D013276:Stomach Ulcer / Q000150:complications; D047368:Tumor Burden
keywords: Lymph node metastasis; Meta-analysis; Undifferentiated early gastric cancer