Surgical Indication for Non-curative Endoscopic Resection in Early Gastric Cancer View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2007-09-26

AUTHORS

Keun Won Ryu, Il Ju Choi, Young Woo Doh, Myeong-Cherl Kook, Chan Gyoo Kim, Hyun-Jung Park, Jun Ho Lee, Jong-Seok Lee, Jong Yeul Lee, Young Woo Kim, Jae-Moon Bae

ABSTRACT

BackgroundEndoscopic resection (ER) is an effective treatment for early gastric cancer (EGC) without lymph node metastasis. However, after ER additional surgery may be needed to manage the risks presented by residual cancer or lymph node metastasis.MethodsER was performed on 344 gastric adenocarcinomas between November 2001 and April 2006 at the Korean National Cancer Center under the strict pre-procedural indication. The authors performed operations in 43 patients due to: residual mucosal cancer, a mucosal cancer larger than 3 cm, or a submucosal cancer regardless of size or margin involvement. ER and surgical specimens were reviewed and analyzed for residual cancer and lymph node metastasis.ResultsBased on examinations of ER specimens, cancer was confined to the mucosal layer in 15 patients (34.9%) and invaded the submucosal layer in 28 patients (65.1%). Surgical specimens showed residual cancer in 17 patients (39.5%) and lymph node metastasis in four (9.3%). Neither residual cancer nor lymph node metastasis was found in patients with less than 500 μm submucosal invasion without margin involvement in ER specimens. In three of four patients with lymph node metastasis, the depth of submucosal invasion was 500 μm or more; the remaining patient had a 4-cm-sized differentiated mucosal cancer.ConclusionsWhen a pathologic evaluation of an ER specimen reveals more than 500 μm of submucosal invasion or a mucosal cancer of larger than 3 cm, surgery should be considered due to the risk of lymph node metastasis. More... »

PAGES

3428-3434

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-007-9536-z

DOI

http://dx.doi.org/10.1245/s10434-007-9536-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1042672654

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/17899290


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33 schema:description BackgroundEndoscopic resection (ER) is an effective treatment for early gastric cancer (EGC) without lymph node metastasis. However, after ER additional surgery may be needed to manage the risks presented by residual cancer or lymph node metastasis.MethodsER was performed on 344 gastric adenocarcinomas between November 2001 and April 2006 at the Korean National Cancer Center under the strict pre-procedural indication. The authors performed operations in 43 patients due to: residual mucosal cancer, a mucosal cancer larger than 3 cm, or a submucosal cancer regardless of size or margin involvement. ER and surgical specimens were reviewed and analyzed for residual cancer and lymph node metastasis.ResultsBased on examinations of ER specimens, cancer was confined to the mucosal layer in 15 patients (34.9%) and invaded the submucosal layer in 28 patients (65.1%). Surgical specimens showed residual cancer in 17 patients (39.5%) and lymph node metastasis in four (9.3%). Neither residual cancer nor lymph node metastasis was found in patients with less than 500 μm submucosal invasion without margin involvement in ER specimens. In three of four patients with lymph node metastasis, the depth of submucosal invasion was 500 μm or more; the remaining patient had a 4-cm-sized differentiated mucosal cancer.ConclusionsWhen a pathologic evaluation of an ER specimen reveals more than 500 μm of submucosal invasion or a mucosal cancer of larger than 3 cm, surgery should be considered due to the risk of lymph node metastasis.
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45 Korean National Cancer Center
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48 adenocarcinoma
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52 depth
53 early gastric cancer
54 effective treatment
55 endoscopic resection
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58 gastric adenocarcinoma
59 gastric cancer
60 indications
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62 involvement
63 layer
64 lymph
65 lymph node metastasis
66 margin involvement
67 metastasis
68 mucosal cancer
69 mucosal layer
70 node metastasis
71 non-curative endoscopic resection
72 operation
73 pathologic evaluation
74 patients
75 resection
76 residual cancer
77 risk
78 size
79 specimen
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81 submucosal cancer
82 submucosal invasion
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