Details

Autor(en) / Beteiligte

• Kim, Hae Won, MD
• Kim, Jie-Hyun, MD, PhD
• Park, Jun Chul, MD
• Jeon, Mi Young
• Lee, Yong Chan, MD, PhD
• Lee, Sang Kil, MD, PhD
• Shin, Sung Kwan, MD
• Chung, Hyun Soo, MD, PhD
• Noh, Sung Hoon, MD, PhD
• Kim, Jong Won, MD, PhD
• Choi, Seung Ho, MD, PhD
• Park, Jae Jun, MD, PhD
• Youn, Young Hoon, MD, PhD
• Park, Hyojin, MD, PhD

Titel

Additive endoscopic resection may be sufficient for patients with a positive lateral margin after endoscopic resection of early gastric cancer

Ist Teil von

• Gastrointestinal endoscopy, 2017-11, Vol.86 (5), p.849-856

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• Background and Aims No well-established treatment strategies exist for lateral margin positivity (LM+) alone after endoscopic resection (ER) of early gastric cancer (EGC). Thus, we aimed to clarify a treatment strategy for non-curative resection (non-CR) with LM+ alone after ER in EGC. Methods Among 2065 patients with EGC treated by ER, 76 (3.6%) with only LM+ after non-CR of EGC were reviewed retrospectively. Of these, 28 underwent gastrectomy, 25 underwent argon plasma coagulation (APC), and 23 underwent repeat ER (re-ER). We analyzed the clinicopathologic characteristics of all patients and compared those who underwent additive surgery, APC, or re-ER. Results Of the 76 patients, 28 (36.8%) fulfilled the absolute criteria and 48 (63.2%) the expanded criteria for ER. Among the latter patients, the proportion undergoing additive surgery was 75.0%, higher than that of patients in the former group ( P  = .014). Residual cancer cells were observed in 70.6% of patients after additive surgery or re-ER. Residual cancer cells were observed significantly more often in patients with undifferentiated-type than in those with differentiated-type EGC ( P  = .02). However, no lymph node metastasis was observed in any patient after additive surgery. Conclusions Our results suggest that endoscopic treatment may be a sufficient additive therapy for patients with LM+ alone after ER, irrespective of whether the absolute or expanded ER criteria are used. However, as complete ablation of remnant cells cannot be guaranteed, re-ER is a better additive treatment than APC.