Discrepancy between Clinical and Final Pathological Evaluation Findings in Early Gastric Cancer Patients Treated with Endoscopic Submucosal Dissection

김영일; 김형상; 국명철; 조수정; 이종열; 김찬규; 류근원; 김영우; 최일주

doi:http://dx.doi.org/10.5230/jgc.2016.16.1.34

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자료유형: 학술저널

저자정보: 김영일 (국립암센터) 김형상 (국립암센터) 국명철 (국립암센터) 조수정 (국립암센터) 이종열 (국립암센터) 김찬규 (국립암센터) 류근원 (국립암센터) 김영우 (국립암센터) 최일주 (국립암센터)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제16권 제1호

발행연도: 2016.3

수록면: 34 - 42 (9page)

DOI: http://dx.doi.org/10.5230/jgc.2016.16.1.34

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Purpose: Early gastric cancer cases that are estimated to meet indications for treatment before endoscopic submucosal resection are often revealed to be out-of-indication after the treatment. We investigated the short-term treatment outcomes in patients with early gastric cancer according to the pretreatment clinical endoscopic submucosal resection indications. Materials and Methods: We retrospectively reviewed the medical records of patients with early gastric cancer that met the pretreatment endoscopic submucosal resection indications, from 2004 to 2011. Curative resection rate and proportion of out-of-indication cases were compared according to the pre-endoscopic submucosal resection indications. Pre-endoscopic submucosal resection factors associated with out-of-indication in the final pathological examination were analyzed. Results: Of 756 cases, 660 had absolute and 96 had expanded pre-endoscopic submucosal resection indications. The curative resection rate was significantly lower in the patients with expanded indications (64.6%) than in those with absolute indications (81.7%; P<0.001). The cases with expanded indications (30.2%) were revealed to be out-of-indication more frequently than the cases with absolute indications (13.8%; P<0.001). Age of >65 years, tumor size of >2 cm, tumor location in the upper-third segment of the stomach, and undifferentiated histological type in pre-endoscopic submucosal resection evaluations were significant risk factors for outof- indication after endoscopic submucosal resection. Conclusions: Non-curative resection due to out-of-indication occurred in approximately one-third of the early gastric cancer cases that clinically met the expanded indications before endoscopic submucosal resection. The possibility of additional surgery should be emphasized for patients with early gastric cancers that clinically meet the expanded indications.

#Endoscopic submucosal dissection #Early gastric cancer #Criteria

참고문헌 (31)

참고문헌 신청

이준행 / 2014 / Clinical Practice Guidelines for Gastric Cancer in Korea: An Evidence-Based Approach / Journal of Gastric Cancer 14(2):87~104

Japanese Gastric Cancer Association / 2011 / Japanese gastric cancer treatment guidelines 2010 (ver. 3) / Gastric Cancer 14:113~123

Ahn JY / 2011 / Endoscopic and oncologic outcomes after endoscopic resection for early gastric cancer : 1370 cases of absolute and extended indications / Gastrointest Endosc 74:485~493

Isomoto H / 2009 / Endoscopic submucosal dissection for early gastric cancer : a large-scale feasibility study / Gut 58:331~336

Gotoda T / 2010 / Endoscopic resection of early gastric cancer treated by guideline and expanded National Cancer Centre criteria / Br J Surg 97:868~871

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주요연구분야 의약학 > 의학 일반 의약학 > 임상의학 > 일반 외과학

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