Factors related to lymph node metastasis and the feasibility of endoscopic mucosal resection for treating poorly differentiated adenocarcinoma of the stomach

Park, Y. D.; Chung, Yun Jin; Chung, H. Y.; Yu, Wansik; Bae, Hwallip; Jeon, Seong Woo; Cho, C. M.; Tak, Won Young; Kweon, Young-Oh

doi:10.1055/s-2007-966750

Cited by 103 publications

(78 citation statements)

References 10 publications

(17 reference statements)

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“…The probability of lymph node metastasis ranges from 10.2 to 22.9% in cases of SM-GC [25][26][27][28][29]. As we reported previously [30], when examining SM-GCs, it is important to take into account the histologic type of the deepest invasive portion in addition to the main histologic type.…”

Section: Discussionmentioning

confidence: 92%

Clinical validity of endoscopic submucosal dissection for submucosal invasive gastric cancer: a single-center study

et al. 2011

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Background The 2010 Japanese Gastric Cancer Association guidelines for the treatment of submucosal invasive gastric cancer (SM-GC) specify size 30 mm or less, differentiated-dominant histology, lack of vessel involvement, and submucosal invasion of less than 500 lm (SM1) as expanded criteria for curative endoscopic resection. Our purpose in this study was to confirm the validity of the expanded indications for curative endoscopic submucosal dissection (ESD) of SM-GC. Methods The study subjects were 173 patients with SM-GC resected by ESD at Hiroshima University Hospital between April 2002 and September 2010, including 99 patients for whom 3-plus years' follow-up information was available. Post-ESD outcomes were compared between cases of SM1-GC that met the expanded ESD criteria, those that did not, and SM2-GC cases.Results Complete resection was achieved for 93.2% of the SM1-GCs that met the expanded criteria. There was neither metastasis to lymph nodes or other organs nor local recurrence among the SM1-GCs. Disease-specific survival did not differ significantly between patients that were simply followed up after ESD and those that were treated by additional surgical resection. Conclusions Our outcome data support the clinical validity of ESD without additional surgical resection for SM1-GCs that meet the expanded criteria.

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Section: Discussionmentioning

confidence: 92%

Clinical validity of endoscopic submucosal dissection for submucosal invasive gastric cancer: a single-center study

et al. 2011

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“…Therefore, an expanded set of criteria for ER has been proposed. The upper limit of the 95% CI calculated from these early studies, however, was too broad for clinical use, because of the small sample size in those studies [24][25][26][27][28][29][30][31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer

Gotoda²,

et al. 2009

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“…The upper limit of the 95% confi dence interval was 2.6%, which was considered to be suffi ciently large to exclude the possibility of lymph node metastasis. Some predictive factors for lymph node metastasis in undifferentiated EGC have been reported [7][8][9][10][11]. Previously, we retrospectively examined factors predictive of lymph node metastasis in 332 patients with undifferentiated EGC who underwent gastrectomy, including the present patient.…”

Section: Discussionmentioning

confidence: 91%

A case of small undifferentiated intramucosal gastric cancer with lymph node metastasis

et al. 2010

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include larger, differentiated intramucosal adenocarcinoma and undifferentiated adenocarcinoma less than 20 mm in diameter and without ulceration. Case reportA 60-year-old Japanese woman visited a local hospital because of anorexia and body weight loss, and gastroscopy revealed gastric cancer. She was admitted to our hospital for the treatment of gastric cancer in October 2001. She had no history of malignant disease and no family history of cancer. Upper gastrointestinal endoscopy revealed irregular, depressed mucosa, type 0 IIc in accordance with the Japanese classifi cation of gastric carcinoma (JCGC) [4] in the large curvature of the lower gastric body (Fig. 1). The diameter was approximately 1 cm, and there were no ulcer fi ndings. Endoscopic ultrasonography revealed this to be an intramucosal cancer, and computed tomography examination showed no distinct lymph node metastasis. Pathologically, signet-ring cell carcinoma was detected in the biopsy specimen. Laboratory results were within normal limits, and serum carcinoembryonic antigen (CEA) levels were normal. Wedge resection of the stomach with resection of a single lymph node (#4d) was performed in November 2001 (Fig. 2). Histological examination revealed that signet-ring cell carcinoma was located in approximately one-third of the superficial portion of the mucosal layer and that carcinoma cells had not invaded into the muscularis mucosa (Fig. 3A, B). The tumor was 13 mm in size. No lymphatic invasion, venous invasion (immunohistochemical staining with CD34 and D2-40), or ulcer scar was observed in the submucosal layer. Histologically, there was no fi brosis in the submucosal layer and no breakdown of the muscularis mucosa. The resection margin was clear of tumor cells. The single resected lymph node had metastatic cancer cells; these were also signet-ring cell car-

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Factors related to lymph node metastasis and the feasibility of endoscopic mucosal resection for treating poorly differentiated adenocarcinoma of the stomach

Abstract: Poorly differentiated EGC confined to the mucosa or with minimal submucosal infiltration (

Cited by 103 publications

References 10 publications

Clinical validity of endoscopic submucosal dissection for submucosal invasive gastric cancer: a single-center study

Clinical validity of endoscopic submucosal dissection for submucosal invasive gastric cancer: a single-center study

Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer

A case of small undifferentiated intramucosal gastric cancer with lymph node metastasis

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