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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 em En | WPRIM | ID: wpr-714615
Biblioteca responsável: 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.
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Texto completo: 1 Base de dados: WPRIM Assunto principal: Neoplasias Gástricas / Biópsia / Adenocarcinoma / Estudos de Coortes / Carcinoma de Células em Anel de Sinete / Gastrectomia / Linfonodos / Metástase Neoplásica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies Limite: Humans Idioma: En Revista: Gut and Liver Ano de publicação: 2018 Tipo de documento: Article
Texto completo: 1 Base de dados: WPRIM Assunto principal: Neoplasias Gástricas / Biópsia / Adenocarcinoma / Estudos de Coortes / Carcinoma de Células em Anel de Sinete / Gastrectomia / Linfonodos / Metástase Neoplásica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies Limite: Humans Idioma: En Revista: Gut and Liver Ano de publicação: 2018 Tipo de documento: Article