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Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review

This study evaluated the possibility of endoscopic submucosal dissection (ESD) for early gastric cancer with papillary adenocarcinoma (EGC-PAC). PAC, an uncommon pathologic type of stomach cancer, is classified into differentiated-type histology. However, aggressive features, including a high rate o...

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Autores principales: Bang, Chang Seok, Lee, Jae Jun, Baik, Gwang Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290846/
https://www.ncbi.nlm.nih.gov/pubmed/32422868
http://dx.doi.org/10.3390/jcm9051465
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author Bang, Chang Seok
Lee, Jae Jun
Baik, Gwang Ho
author_facet Bang, Chang Seok
Lee, Jae Jun
Baik, Gwang Ho
author_sort Bang, Chang Seok
collection PubMed
description This study evaluated the possibility of endoscopic submucosal dissection (ESD) for early gastric cancer with papillary adenocarcinoma (EGC-PAC). PAC, an uncommon pathologic type of stomach cancer, is classified into differentiated-type histology. However, aggressive features, including a high rate of submucosal invasion, lymphovascular invasion (LVI), and lymph node metastasis (LNM), have been reported in studies with surgical specimens. Treatment outcomes of ESD for EGC-PAC have not been precisely demonstrated. Core databases were sought for the following inclusion criteria: studies of endoscopic resection or surgery of EGC-PAC presenting the following therapeutic indicators; en bloc resection, complete resection, curative resection, recurrence, complications associated with procedures, LVI, or LNM that enabled an analysis of ESD possibility. Overall, 15 studies were included for systematic review. Frequent submucosal invasion and high LVI were noted in EGC-PAC. However, PAC was not significantly associated with LNM. Pooled en bloc resection, complete resection, and curative resection rates were 89.7% (95% confidence interval: 55.3%–98.4%), 85.3% (67.7%–94.2%), and 67% (43%–84.5%), respectively. No LNM was observed if EGC-PAC satisfied the curative resection criteria. ESD seems technically feasible, although a high LVI rate results in a lower rate of curative resection.
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spelling pubmed-72908462020-06-17 Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review Bang, Chang Seok Lee, Jae Jun Baik, Gwang Ho J Clin Med Article This study evaluated the possibility of endoscopic submucosal dissection (ESD) for early gastric cancer with papillary adenocarcinoma (EGC-PAC). PAC, an uncommon pathologic type of stomach cancer, is classified into differentiated-type histology. However, aggressive features, including a high rate of submucosal invasion, lymphovascular invasion (LVI), and lymph node metastasis (LNM), have been reported in studies with surgical specimens. Treatment outcomes of ESD for EGC-PAC have not been precisely demonstrated. Core databases were sought for the following inclusion criteria: studies of endoscopic resection or surgery of EGC-PAC presenting the following therapeutic indicators; en bloc resection, complete resection, curative resection, recurrence, complications associated with procedures, LVI, or LNM that enabled an analysis of ESD possibility. Overall, 15 studies were included for systematic review. Frequent submucosal invasion and high LVI were noted in EGC-PAC. However, PAC was not significantly associated with LNM. Pooled en bloc resection, complete resection, and curative resection rates were 89.7% (95% confidence interval: 55.3%–98.4%), 85.3% (67.7%–94.2%), and 67% (43%–84.5%), respectively. No LNM was observed if EGC-PAC satisfied the curative resection criteria. ESD seems technically feasible, although a high LVI rate results in a lower rate of curative resection. MDPI 2020-05-14 /pmc/articles/PMC7290846/ /pubmed/32422868 http://dx.doi.org/10.3390/jcm9051465 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bang, Chang Seok
Lee, Jae Jun
Baik, Gwang Ho
Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review
title Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review
title_full Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review
title_fullStr Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review
title_full_unstemmed Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review
title_short Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review
title_sort endoscopic submucosal dissection of papillary gastric adenocarcinoma; systematic review
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290846/
https://www.ncbi.nlm.nih.gov/pubmed/32422868
http://dx.doi.org/10.3390/jcm9051465
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