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논문 기본 정보

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학술저널
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대한소화기내시경학회 Clinical Endoscopy Clinical Endoscopy 제44권 제2호
발행연도
2011.1
수록면
116 - 122 (7page)

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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.
#Endoscopic submucosal dissection #Undifferentiated early gastric cancer #Submucosal invasive early gastric cancer

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참고문헌 (19)

참고문헌 신청
/ 2002 / The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon / Gastrointest Endosc 58 : S3 ~ S43 google schola Abe N / 2004 / Endoscopic treatment or surgery for undifferentiated early gastric cancer? / Am J Surg 188 : 181 ~ 184 google schola Cai J / 2000 / Micrometastasis in lymph nodes and microinvasion of the muscularis propria in primary lesions of submucosal gastric cancer / Surgery 127 : 32 ~ 39 google schola Cai J / 2000 / Micrometastasis in lymph nodes of mucosal gastric cancer / Gastric Cancer 3 : 91 ~ 96 google schola Hwoon-Yong Jung / 2010 / Expansion of Indication for Endoscopic SD in Early Gastric Cancer / 대한위암학회지 10 (2) : 49 ~ 54 google schola

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