Exploring the possibility of endoscopic submucosal dissection for clinical submucosal invasive early gastric cancers View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-02-06

AUTHORS

Hyun Deok Lee, Hyunsoo Chung, Sang Gyun Kim, Jung Kim, Jue Lie Kim, Eunwoo Lee, Hyun Chae Jung

ABSTRACT

BackgroundThe current standard treatment modality for clinical submucosal invasive (cT1b) early gastric cancer (EGC) is surgery. However, there are discrepancies in T staging between pre- and post-operative findings, and in cases of overestimation, patients may lose the opportunity to preserve the stomach. The aim of this study was to analyze surgical outcomes of cT1b EGC and determine the pre-treatment factors favoring ESD.MethodsPatients who underwent gastrectomy for cT1b EGC with a tumor size of 30 mm or less in diameter and differentiated-type histology were retrospectively reviewed from January 2010 to December 2014. According to the final surgical pathologic results, two groups were classified: patients whose pathologic results qualified for current ESD indication (ESD-qualified group, n = 203) and patients whose pathologic results made them ineligible for ESD (ESD-disqualified group, n = 261). The preoperative clinical characteristics were compared.ResultsForty-three percent of the patients (203/464) who underwent gastrectomy for cT1b EGC qualified for ESD; their endoscopic lesion tended to be smaller than 20 mm in size and located in the distal part of stomach. In addition, the ESD-qualified group showed a significantly higher proportion of well-differentiated tubular adenocarcinoma on endoscopic biopsy and of the flat/depressed type in the endoscopic evaluation.ConclusionForty-three percent of the patients with cT1b EGC who underwent gastrectomy had a chance to preserve their stomach by ESD. Therefore, pre-treatment factors such as endoscopic lesion size, location, histology, and gross type should be considered for treatment modality selection for cT1b EGC. More... »

PAGES

4008-4015

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-019-06690-5

DOI

http://dx.doi.org/10.1007/s00464-019-06690-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1111933472

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30725253


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