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Endoscopic submucosal dissection for early gastric cancer with undifferentiated histology: could we extend the criteria beyond?

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Author(s)
조광범박경식김은수
Alternative Author(s)
Cho, Kwang BumPark, Kyung SikKim, Eun Soo
Issued Date
2013
Keyword
Early gastric cancerEndoscopic submucosal dissectionUndifferentiated
Abstract
Background Endoscopic submucosal desection (ESD) is
an effective treatment for selected patients with early
gastric cancer (EGC). The purpose of this study was to
examine the short-term and long-term outcomes of ESD of
undifferentiated early gastric cancer.
Methods Data for 1,241 patients who underwent ESD for
treatment of EGC between February 2003 and May 2010
were collected. We performed a retrospective analysis of
the medical records of 74 patients diagnosed with undifferentiated
EGC. We divided the enrolled cases into two
groups: the expanded-criteria group (EC group) versus the
non-EC group, according to lesion size, presence of
ulceration, and pathologic review.
Results Of a total of 74 lesions with undifferentiated
EGC, as a result of pathologic examination the EC group
included 29 cases and the non-EC group included 45 cases.
The mean diameter of lesions was 19.86 ± 12.5 mm. The
overall rates of en bloc resection and complete resection
were 90.5 % (67/74) and 73 % (54/74), respectively. The
curative resection rate was low at 31.1 %. If limited to the
pathologically diagnosed EC group, the curative resection
rate was 79.3 % (23/29). During median follow-up periods
of 34 months (range 7–81), local recurrences were
observed in 5.5 % (4/74) of patients. All of these were in
the non-EC group and all underwent noncurative resection.
There was no mortality related to ESD for treatment of
EGC during follow-up.
Conclusions ESD may be a feasible treatment for selected
patients with undifferentiated EGC; this should be
validated by development of new criteria for ESD for
treatment of EGC.
Keywords Early gastric cancer Endoscopic
submucosal dissection Undifferentiated
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Surgical Endoscopy, Vol.27(12) : 4656–4662-4656–4662, 2013
Type
Article
ISSN
0930-2794
DOI
10.1007/s00464-013-3099-9
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34433
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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