Clin Endosc.  2019 Jan;52(1):9-14. 10.5946/ce.2018.199.

Strategy for Curative Endoscopic Resection of Undifferentiated-Type Early Gastric Cancer

• Kim JH

• KMID: 2438138
• DOI: http://doi.org/10.5946/ce.2018.199

Abstract

Endoscopic resection (ER) of undifferentiated-type early gastric cancer (UD-EGC) has a lower curative resection (CR) rate than differentiated-type EGC. However, if UD-EGC is curatively resected using ER, long-term outcomes can be favorable. Thus, the strategy for CR by ER is important in UD-EGC. To achieve CR in UD-EGC, biological behaviors including tumor growth patterns must be considered. This review aims to describe what is important for curative ER of UD-EGC.

Keyword

Stomach neoplasms; Endoscopic mucosal resection; Histology

MeSH Terms

Stomach Neoplasms*

Figure

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  Fig. 1. Signet ring cell carcinoma (SRC) case with positive lateral margin after endoscopic resection. (A) Endoscopic image of early gastric cancer, showing a depressed lesion located in the posterior wall of the angle. The surrounding mucosa was combined with atrophic gastritis. After endoscopic resection, the lateral margin was positive (arrow). (B) Pathological findings after endoscopic resection (hematoxylin and eosin, ×40). SRC cells showed subepithelial spread. Immunohistochemical staining for CK (AE1/AE3), ×100.

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  Fig. 2. Suggested algorithm for endoscopic resection (ER) of undifferentiated-type early gastric cancer (UD-EGC) based on previous studies (Modified from Kim [39]). PD, poorly differentiated adenocarcinoma; SRC, signet ring cell carcinoma; EUS, endoscopic ultrasonography; IM, intestinal metaplasia; NBI-ME, narrow-band imaging with magnifying endoscopy.

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