Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer with Undifferentiated-Type Histology: A Clinical Simulation Using a Non-Selected Surgical Cohort
Gut and Liver
; : 263-270, 2018.
Article
in En
| WPRIM
| ID: wpr-714615
Responsible library:
WPRO
ABSTRACT
BACKGROUND/AIMS:
Outcomes of endoscopic submucosal dissection (ESD) for undifferentiated-type early gastric cancer (EGC) need to be further evaluated. We aimed to simulate the outcomes of ESD for undifferentiated-type EGC from a surgical database.METHODS:
Among 802 patients who underwent gastrectomy with endoscopic biopsy for poorly differentiated adenocarcinoma (PD-type) or signet ring cell carcinoma (SRC-type), ESD candidates meeting the expanded indication (n=280) were selected by reviewing the endoscopic images. According to the surgical pathologic results, the outcomes of the ESD simulation were evaluated.RESULTS:
Among the candidates, 104 (37.1%) were PD-type and 176 (62.9%) were SRC-type. The curative resection (CR) rate was 42.1%. Among the patients with CR, three patients (2.5%) showed lymph node metastasis (LNM). Three EGCs with CR and LNM were mucosal cancers ≥1.0 cm in size. The CR rate was higher in the SRC-type than in the PD-type (48.3% vs 31.7%, respectively, p=0.007). In the SRC-type, the CR rate was increased, with a smaller size criterion for the ESD indication, but was similar between the 1.0 cm and 0.6 cm criteria (63.3% and 63.6%, respectively), whereas the CR rate was below 50% in all of the different tumor size criteria (2.0 to 0.6 cm) in the PD-type.CONCLUSIONS:
In undifferentiated-type EGC, ESD should be considered in selected patients with tumor sizes < 1 cm and SRC histology.Key words
Full text:
1
Database:
WPRIM
Main subject:
Stomach Neoplasms
/
Biopsy
/
Adenocarcinoma
/
Cohort Studies
/
Carcinoma, Signet Ring Cell
/
Gastrectomy
/
Lymph Nodes
/
Neoplasm Metastasis
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
Limits:
Humans
Language:
En
Journal:
Gut and Liver
Year:
2018
Document type:
Article