Contribution of endoscopy to diagnosis and treatment of gastric cancer

Sekons, David H.; McSherry, Charles K.; Calhoun, W.Ford; Pudalov, Barbara; Beaton, Howard L.; Shinya, Hiromi

doi:10.1016/0002-9610(84)90136-3

Cited by 11 publications

(2 citation statements)

References 11 publications

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“…Before determining the criteria for limited surgery for early gastric carcinomas, we should consider again the following: Endoscopically diagnosed cancers show wide variations in microscopic size [21]; the depth of cancer invasion is misdiagnosed in fewer than 20% of cases [22,23]; the presence or absence of nodal involvement cannot be accurately diagnosed preoperatively or intraoperatively [17]; inappropriate dissection of lymph nodes may cause postoperative recurrence leading to poorer survival [16]; and the prophylactic dissection of lymph nodes does not contribute to postoperative mortality [24].…”

Section: Discussionmentioning

confidence: 99%

Assessing the Suitability of Gastric Carcinoma for Limited Resection: Endoscopic Prediction of Lymph Node Metastases

et al. 1998

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Some early gastric carcinomas are free of lymph node involvement; however, the pathosis of these carcinomas is neither well understood nor reflected in the choice of less extensive treatment. We investigated the relation of nodal involvement to pathologic findings of the resected specimens. We present promising standards for predicting the nodal status of early gastric carcinomas, contributing to the indication for limited surgery. The relation of lymph node metastasis to tumor size, infiltration depth, macroscopic appearance, and histologic type of early gastric carcinomas were investigated in 1470 patients with a single primary early gastric carcinoma. Of these carcinomas, 763 were limited to the mucosa (mucosal carcinoma) and 707 to the submucosa (submucosal carcinoma). The overall incidence of lymph node metastasis was 9.0%: 2.1% in mucosal carcinomas and 16.5% in submucosal ones, with a significant (p < 0.001) difference of nodal involvement between the two. The macroscopically elevated or compound-type carcinomas 10 mm or less in diameter were all node-negative, whereas some depressed-type carcinomas were node-positive. The incidence of undifferentiated carcinomas increased with tumor diameter, irrespective of whether they were mucosal or submucosal carcinomas, and they were significantly more node-positive than were differentiated carcinomas: p < 0.001 for mucosal carcinomas and p < 0.05 for submucosal ones. The carcinomas satisfying the following criteria are node-negative and eligible for limited surgery: (1) mucosal carcinoma; (2) elevated lesion < 10 mm in diameter; (3) differentiated adenocarcinoma; and (4) no ulcer or ulcer scar. The other carcinomas are potentially node-positive and standard surgery is recommended.

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Section: Discussionmentioning

confidence: 99%

Assessing the Suitability of Gastric Carcinoma for Limited Resection: Endoscopic Prediction of Lymph Node Metastases

et al. 1998

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“…Improvements in the diagnostic accuracy for the early detection of gastric cancer, using endoscopy and mass screening systems (Hisamichi and Sugawara, 1984;Sekons et al, 1984;Longo et al, 1987), have greatly contributed to the decreased presentation of advanced gastric cancers over the past 20 years (Hisamichi et al, 1987). With regard to the histological types, since diagnostic accuracy for early detection is influenced by histological type-associated clinicopathological factors, such as tumour location, sex and age, there is a different degree of diagnostic accuracy for early detection between differentiated and undifferentiated types of gastric cancer (Mori et al, 1989), and either of the two histological types may often be overlooked in the early stage.…”

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confidence: 99%

Improvements in diagnosis have changed the incidence of histological types in advanced gastric cancer

Ikeda

Mori²,

Kamakura³

et al. 1995

Br J Cancer

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SummaryThe data on 912 patients with early cancer and 1245 with advanced cancer who were seen between 1971 and 1990 were compared. The incidence of undifferentiated-type cancer increased significantly in patients with advanced gastric cancer, but not in patients with early gastric cancer. When the histological types were compared with regard to sex, age and location in patients with early gastric cancer the undifferentiated type was found to increase only in males, while in patients with advanced gastric cancer the undifferentiated type increased in both sexes as well as in younger patients and in both the upper and middle third of the stomach. These differences in the trends between early and advanced cancers are probably due to the different degrees of diagnostic accuracy for the early detection of histological types.

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Early gastric lymphoma: A clinicopathologic study of ten patients, literature review, and comparison with early gastric adenocarcinoma

Kitamura

Yamaguchi

Okamoto

et al. 1996

Cancer

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Contribution of endoscopy to diagnosis and treatment of gastric cancer

Cited by 11 publications

References 11 publications

Assessing the Suitability of Gastric Carcinoma for Limited Resection: Endoscopic Prediction of Lymph Node Metastases

Assessing the Suitability of Gastric Carcinoma for Limited Resection: Endoscopic Prediction of Lymph Node Metastases

Improvements in diagnosis have changed the incidence of histological types in advanced gastric cancer

Early gastric lymphoma: A clinicopathologic study of ten patients, literature review, and comparison with early gastric adenocarcinoma

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