Cargando…

Clinical Outcomes of Endoscopic Submucosal Dissection for Undifferentiated or Submucosal Invasive Early Gastric Cancer

BACKGROUND/AIMS: Early gastric cancer (EGC) that is undifferentiated or shows submucosal invasion has not been generally accepted as an indication for endoscopic treatment. But recently, experiences with endoscopic submucosal dissection (ESD) for undifferentiated EGC or submucosal invasive (SM) EGC...

Descripción completa

Detalles Bibliográficos
Autores principales: Goh, Pyung Gohn, Jeong, Hyun Yong, Kim, Min Jung, Eun, Hyuk Soo, Kim, Hye Jin, Kim, Eui Sik, Kim, Yun Jeung, Lee, Soo Youn, Moon, Hee Seok, Lee, Eaum Seok, Kim, Seok Hyun, Sung, Jae Kyu, Lee, Byung Seok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Gastrointestinal Endoscopy 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363057/
https://www.ncbi.nlm.nih.gov/pubmed/22741122
http://dx.doi.org/10.5946/ce.2011.44.2.116
_version_ 1782234293164048384
author Goh, Pyung Gohn
Jeong, Hyun Yong
Kim, Min Jung
Eun, Hyuk Soo
Kim, Hye Jin
Kim, Eui Sik
Kim, Yun Jeung
Lee, Soo Youn
Moon, Hee Seok
Lee, Eaum Seok
Kim, Seok Hyun
Sung, Jae Kyu
Lee, Byung Seok
author_facet Goh, Pyung Gohn
Jeong, Hyun Yong
Kim, Min Jung
Eun, Hyuk Soo
Kim, Hye Jin
Kim, Eui Sik
Kim, Yun Jeung
Lee, Soo Youn
Moon, Hee Seok
Lee, Eaum Seok
Kim, Seok Hyun
Sung, Jae Kyu
Lee, Byung Seok
author_sort Goh, Pyung Gohn
collection PubMed
description BACKGROUND/AIMS: Early gastric cancer (EGC) that is undifferentiated or shows submucosal invasion has not been generally accepted as an indication for endoscopic treatment. But recently, experiences with endoscopic submucosal dissection (ESD) for undifferentiated EGC or submucosal invasive (SM) EGC have increased. The aim of this study was to evaluate clinical outcomes of ESD for EGC with undifferentiation or submucosal invasion. METHODS: Between August 2005 and August 2009, among 210 EGCs treated using ESD at our hospital, 18 lesions were diagnosed as undifferentiated gastric cancer and 41 as SM gastric cancer. A retrospective analysis was done on the medical records of these patients. RESULTS: Mean follow-up periods were 19.39±11.2 months. During the follow-up period, local recurrence was noted in 4 lesions. Local recurrence rates of the EGC groups (group 1, mucosal cancer with undifferentiation; group 2, SM cancer with differentiation; group 3, SM cancer with undifferentiation) were 10%, 4.5%, and 50%, respectively. Groups 1 and 2 were not significantly different in local recurrence rates compared to the mucosal cancer with differentiation group (p=0.061, p=0.125, respectively). The undifferentiated EGC group was significantly lower in curability using ESD than the differentiated EGC group (55.6% vs. 89.6%, p=0.000). The curability of the SM EGC group was lower than the mucosal EGC group (36.6% vs. 98.9%). CONCLUSIONS: Complete resection using ESD is difficult in undifferentiated and SM gastric cancers. SM cancer with undifferentiation should be treated immediately by salvage operation. For mucosal cancer with undifferentiation or SM cancer with differentiation, one should consider careful short-term follow-up.
format Online
Article
Text
id pubmed-3363057
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher The Korean Society of Gastrointestinal Endoscopy
record_format MEDLINE/PubMed
spelling pubmed-33630572012-06-27 Clinical Outcomes of Endoscopic Submucosal Dissection for Undifferentiated or Submucosal Invasive Early Gastric Cancer Goh, Pyung Gohn Jeong, Hyun Yong Kim, Min Jung Eun, Hyuk Soo Kim, Hye Jin Kim, Eui Sik Kim, Yun Jeung Lee, Soo Youn Moon, Hee Seok Lee, Eaum Seok Kim, Seok Hyun Sung, Jae Kyu Lee, Byung Seok Clin Endosc Original Article BACKGROUND/AIMS: Early gastric cancer (EGC) that is undifferentiated or shows submucosal invasion has not been generally accepted as an indication for endoscopic treatment. But recently, experiences with endoscopic submucosal dissection (ESD) for undifferentiated EGC or submucosal invasive (SM) EGC have increased. The aim of this study was to evaluate clinical outcomes of ESD for EGC with undifferentiation or submucosal invasion. METHODS: Between August 2005 and August 2009, among 210 EGCs treated using ESD at our hospital, 18 lesions were diagnosed as undifferentiated gastric cancer and 41 as SM gastric cancer. A retrospective analysis was done on the medical records of these patients. RESULTS: Mean follow-up periods were 19.39±11.2 months. During the follow-up period, local recurrence was noted in 4 lesions. Local recurrence rates of the EGC groups (group 1, mucosal cancer with undifferentiation; group 2, SM cancer with differentiation; group 3, SM cancer with undifferentiation) were 10%, 4.5%, and 50%, respectively. Groups 1 and 2 were not significantly different in local recurrence rates compared to the mucosal cancer with differentiation group (p=0.061, p=0.125, respectively). The undifferentiated EGC group was significantly lower in curability using ESD than the differentiated EGC group (55.6% vs. 89.6%, p=0.000). The curability of the SM EGC group was lower than the mucosal EGC group (36.6% vs. 98.9%). CONCLUSIONS: Complete resection using ESD is difficult in undifferentiated and SM gastric cancers. SM cancer with undifferentiation should be treated immediately by salvage operation. For mucosal cancer with undifferentiation or SM cancer with differentiation, one should consider careful short-term follow-up. The Korean Society of Gastrointestinal Endoscopy 2011-12 2011-12-31 /pmc/articles/PMC3363057/ /pubmed/22741122 http://dx.doi.org/10.5946/ce.2011.44.2.116 Text en Copyright © 2011 The Korean Society of Gastrointestinal Endoscopy http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Goh, Pyung Gohn
Jeong, Hyun Yong
Kim, Min Jung
Eun, Hyuk Soo
Kim, Hye Jin
Kim, Eui Sik
Kim, Yun Jeung
Lee, Soo Youn
Moon, Hee Seok
Lee, Eaum Seok
Kim, Seok Hyun
Sung, Jae Kyu
Lee, Byung Seok
Clinical Outcomes of Endoscopic Submucosal Dissection for Undifferentiated or Submucosal Invasive Early Gastric Cancer
title Clinical Outcomes of Endoscopic Submucosal Dissection for Undifferentiated or Submucosal Invasive Early Gastric Cancer
title_full Clinical Outcomes of Endoscopic Submucosal Dissection for Undifferentiated or Submucosal Invasive Early Gastric Cancer
title_fullStr Clinical Outcomes of Endoscopic Submucosal Dissection for Undifferentiated or Submucosal Invasive Early Gastric Cancer
title_full_unstemmed Clinical Outcomes of Endoscopic Submucosal Dissection for Undifferentiated or Submucosal Invasive Early Gastric Cancer
title_short Clinical Outcomes of Endoscopic Submucosal Dissection for Undifferentiated or Submucosal Invasive Early Gastric Cancer
title_sort clinical outcomes of endoscopic submucosal dissection for undifferentiated or submucosal invasive early gastric cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363057/
https://www.ncbi.nlm.nih.gov/pubmed/22741122
http://dx.doi.org/10.5946/ce.2011.44.2.116
work_keys_str_mv AT gohpyunggohn clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT jeonghyunyong clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT kimminjung clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT eunhyuksoo clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT kimhyejin clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT kimeuisik clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT kimyunjeung clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT leesooyoun clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT moonheeseok clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT leeeaumseok clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT kimseokhyun clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT sungjaekyu clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer
AT leebyungseok clinicaloutcomesofendoscopicsubmucosaldissectionforundifferentiatedorsubmucosalinvasiveearlygastriccancer