Clinical outcomes of endoscopic resection for undifferentiated intramucosal early gastric cancer larger than 2 cm
- 주제(키워드) Endoscopic mucosal resection , Lymph node metastasis , Stomach neoplasms , Treatment outcome , Undifferentiated-type histology
- 등재 SCIE, SCOPUS
- OA유형 Bronze
- 발행기관 Springer Japan
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000181359
- 본문언어 영어
- Published As http://dx.doi.org/10.1007/s10120-020-01115-y
- PubMed https://pubmed.ncbi.nlm.nih.gov/32833124
- 저작권 이화여자대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Background: This study investigated the long-term clinical outcomes of endoscopic resection (ER) for undifferentiated-type (UD) early gastric cancer (EGC), with tumor size > 2 cm as the only non-curative factor. Methods: From among 1123 patients who underwent ER for UD EGC at 18 tertiary hospitals in Korea between 2005 and 2014, we identified 216 patients with UD intramucosal EGC > 2 cm, which was completely resected, with negative resection margins, and absence of ulceration and lymphovascular invasion. The patients were divided into the additional surgery (n = 40) or observation (n = 176) groups, according to post-ER management and were followed up for a median duration of 59 months for recurrence and 90 months for overall survival. Results: Lymph node (LN) or distant metastasis or cancer-related mortality was not observed in the surgery group. In the observation group, two (1.1%) patients developed LN or distant metastasis with a 5-year cumulative risk of 0.7%, and one (0.6%) patient died of gastric cancer. The 5- and 8-year overall survival rates were 94.1% and 89.9%, respectively, in the observation group and 100.0% and 95.2%, respectively, in the surgery group (log-rank P = 0.159). Cox regression analysis did not reveal an association between the observation group and increased mortality. Conclusion: The risk of LN or distant metastasis was not negligible, but as low as 1% for patients undergoing non-curative ER for UD EGC, with tumor size > 2 cm as the only non-curative factor. Close observation may be an alternative to surgery, especially for older patients or those with poor physical status. © 2020, The International Gastric Cancer Association and The Japanese Gastric Cancer Association.
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