지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2011.3
- 수록면
- 165 - 171 (7page)
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초록· 키워드
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Purpose: To evaluate the necessity for additional surgical treatment after Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD), we analyzed the pathologic results of patients who underwent surgical treatment.
Methods: 140 consecutive patients underwent additional surgical treatment after EMR/ESD with en bloc resection between April 2005 and November 2009 at ASAN Medical Center. Additional surgical treatments were undergone for following conditions such as incomplete dissection (involvement of margin), undifferentiated-type histology (≥2 ㎝) and submucosal cancer.
Results: One patient with deep margin involvement displayed advanced gastric cancer after gastrectomy. Three of 74 patients with clear resection margin were confirmed to have residual cancer at ESD site and 2 of 3 patients displayed advanced gastric cancer after surgery. In univariate analysis for metastasis of lymph node, deep submucosal invasion (over sm2 or 500㎛) and the presence of lymphovascular invasion showed significant differences for lymph node metastasis. Especially, lymphovascular invasion was an important predictive factor for lymph node metastasis in multivariate analysis. In analysis for residual cancer, lateral margin involvement and large tumor (＞3 ㎝) were risk factors. And, only lateral margin involvement showed significant risk in multivariate analysis.
Conclusion: Although EMR/ESD were fully accomplished for resection margin, gastrectomy and lymph node dissection were positively necessary for patients with deepsubmucosal invasion (over sm2 or 500㎛) and the presence of lymphovascular invasion to eliminate the possibility of residual cancer or more advanced gastric cancer or metastatic lymph nodes.
Methods: 140 consecutive patients underwent additional surgical treatment after EMR/ESD with en bloc resection between April 2005 and November 2009 at ASAN Medical Center. Additional surgical treatments were undergone for following conditions such as incomplete dissection (involvement of margin), undifferentiated-type histology (≥2 ㎝) and submucosal cancer.
Results: One patient with deep margin involvement displayed advanced gastric cancer after gastrectomy. Three of 74 patients with clear resection margin were confirmed to have residual cancer at ESD site and 2 of 3 patients displayed advanced gastric cancer after surgery. In univariate analysis for metastasis of lymph node, deep submucosal invasion (over sm2 or 500㎛) and the presence of lymphovascular invasion showed significant differences for lymph node metastasis. Especially, lymphovascular invasion was an important predictive factor for lymph node metastasis in multivariate analysis. In analysis for residual cancer, lateral margin involvement and large tumor (＞3 ㎝) were risk factors. And, only lateral margin involvement showed significant risk in multivariate analysis.
Conclusion: Although EMR/ESD were fully accomplished for resection margin, gastrectomy and lymph node dissection were positively necessary for patients with deepsubmucosal invasion (over sm2 or 500㎛) and the presence of lymphovascular invasion to eliminate the possibility of residual cancer or more advanced gastric cancer or metastatic lymph nodes.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (23)
참고문헌 신청
1. [학술지(정기간행물)] - Japanese Gastric Cancer A / 1998 / Japanese Classification of Gastric Carcinoma - 2nd English Edition / Gastric Cancer 1 : 10 ~ 24
2. [학술지(정기간행물)] - Polkowski M / 2004 / Endosonography versus helical computed tomography for locoregional staging of gastric cancer / Endoscopy 36 : 617 ~ 623
3. [학술지(정기간행물)] - Tsendsuren T / 2006 / Usefulness of endoscopic ultrasonography in preoperative TNM staging of gastric cancer / World J Gastroenterol 12 : 43 ~ 47
4. [학술지(정기간행물)] - Furukawa H / 2002 / The role of surgery in the current treatment of gastric carcinoma / Gastric Cancer 5 (Suppl 1) : 13 ~ 16
5. [학술지(정기간행물)] - Ono H / 2005 / Endoscopic submucosal dissection for early gastric cancer / Chin J Dig Dis 6 : 119 ~ 121
2. [학술지(정기간행물)] - Polkowski M / 2004 / Endosonography versus helical computed tomography for locoregional staging of gastric cancer / Endoscopy 36 : 617 ~ 623
3. [학술지(정기간행물)] - Tsendsuren T / 2006 / Usefulness of endoscopic ultrasonography in preoperative TNM staging of gastric cancer / World J Gastroenterol 12 : 43 ~ 47
4. [학술지(정기간행물)] - Furukawa H / 2002 / The role of surgery in the current treatment of gastric carcinoma / Gastric Cancer 5 (Suppl 1) : 13 ~ 16
5. [학술지(정기간행물)] - Ono H / 2005 / Endoscopic submucosal dissection for early gastric cancer / Chin J Dig Dis 6 : 119 ~ 121
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