H Jung1, J M Bae, M G Choi, J H Noh, T S Sohn, S Kim. 1. Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
Abstract
BACKGROUND: Endoscopic resection of early gastric cancer is a relatively new and attractive treatment, but occasionally fails to remove all cancer lesions completely. This study aimed to elucidate clinicopathological factors that could be helpful in predicting residual tumour in the surgical specimen after incomplete endoscopic submucosal dissection (ESD). METHODS: Patients who underwent gastrectomy because of incomplete ESD between August 2004 and August 2008 were analysed. Clinicopathological characteristics were reviewed retrospectively from prospectively collected medical records. Patients were classified into groups with and without residual tumour. Pathology results following gastrectomy were compared with those of incomplete ESD. RESULTS: A total of 118 patients were included. The incidence of residual tumour in the surgical specimen was 24·6 per cent after incomplete ESD. Elevated/flat-type cancers, large tumours (at least 2 cm) and those limited to the mucosa had significantly higher incomplete ESD rates. Cancer limited to the mucosa and the presence of tumour in the lateral margin were associated with residual tumour in the surgical specimen (both P = 0·001). CONCLUSION: Radical gastrectomy should be performed if pathological examination reveals a positive lateral resection margin after ESD.
BACKGROUND: Endoscopic resection of early gastric cancer is a relatively new and attractive treatment, but occasionally fails to remove all cancer lesions completely. This study aimed to elucidate clinicopathological factors that could be helpful in predicting residual tumour in the surgical specimen after incomplete endoscopic submucosal dissection (ESD). METHODS:Patients who underwent gastrectomy because of incomplete ESD between August 2004 and August 2008 were analysed. Clinicopathological characteristics were reviewed retrospectively from prospectively collected medical records. Patients were classified into groups with and without residual tumour. Pathology results following gastrectomy were compared with those of incomplete ESD. RESULTS: A total of 118 patients were included. The incidence of residual tumour in the surgical specimen was 24·6 per cent after incomplete ESD. Elevated/flat-type cancers, large tumours (at least 2 cm) and those limited to the mucosa had significantly higher incomplete ESD rates. Cancer limited to the mucosa and the presence of tumour in the lateral margin were associated with residual tumour in the surgical specimen (both P = 0·001). CONCLUSION: Radical gastrectomy should be performed if pathological examination reveals a positive lateral resection margin after ESD.
Authors: Hyun Jung Lee; Gwang Ha Kim; Do Youn Park; Young Keum Kim; Hye Kyung Jeon; Bong Eun Lee; Geun Am Song Journal: Gastric Cancer Date: 2017-03-07 Impact factor: 7.370
Authors: Geum Youb Noh; Ha Ra Ku; Youn Joo Kim; Su Cheol Park; Jin Kim; Chul Ju Han; Yu Chul Kim; Ki Young Yang Journal: Surg Endosc Date: 2014-12-06 Impact factor: 4.584
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