Hyun Deok Lee1, Hyunsoo Chung2, Sang Gyun Kim1, Jung Kim1, Jue Lie Kim1, Eunwoo Lee1, Hyun Chae Jung1. 1. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. 2. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. hschungmd@gmail.com.
Abstract
BACKGROUND: The 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. METHODS: Patients 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. RESULTS: Forty-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. CONCLUSION: Forty-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.
BACKGROUND: The 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. METHODS:Patients 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. RESULTS: Forty-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. CONCLUSION: Forty-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.
Authors: Young-Il Kim; Young Ae Kim; Chan Gyoo Kim; Keun Won Ryu; Young-Woo Kim; Jin Ah Sim; Young Ho Yun; Il Ju Choi Journal: Surg Endosc Date: 2017-10-24 Impact factor: 4.584
Authors: Chan Hyuk Park; Dong-Hoon Yang; Jong Wook Kim; Jie-Hyun Kim; Ji Hyun Kim; Yang Won Min; Si Hyung Lee; Jung Ho Bae; Hyunsoo Chung; Kee Don Choi; Jun Chul Park; Hyuk Lee; Min-Seob Kwak; Bun Kim; Hyun Jung Lee; Hye Seung Lee; Miyoung Choi; Dong-Ah Park; Jong Yeul Lee; Jeong-Sik Byeon; Chan Guk Park; Joo Young Cho; Soo Teik Lee; Hoon Jai Chun Journal: Clin Endosc Date: 2020-03-30
Authors: Chan Hyuk Park; Dong-Hoon Yang; Jong Wook Kim; Jie-Hyun Kim; Ji Hyun Kim; Yang Won Min; Si Hyung Lee; Jung Ho Bae; Hyunsoo Chung; Kee Don Choi; Jun Chul Park; Hyuk Lee; Min-Seob Kwak; Bun Kim; Hyun Jung Lee; Hye Seung Lee; Miyoung Choi; Dong-Ah Park; Jong Yeul Lee; Jeong-Sik Byeon; Chan Guk Park; Joo Young Cho; Soo Teik Lee; Hoon Jai Chun Journal: Intest Res Date: 2020-10-13