Clin Endosc.  2019 Jan;52(1):30-35. 10.5946/ce.2018.158.

Pitfalls in the Interpretation of Publications about Endoscopic Submucosal Dissection of Early Gastric Cancer with Undifferentiated-Type Histology

• Bang CS
• Baik GH

• KMID: 2438141
• DOI: http://doi.org/10.5946/ce.2018.158

Abstract

Endoscopic submucosal dissection (ESD) is a standard treatment for patients with gastrointestinal neoplasms with a negligible risk of lymph node metastasis. ESD enables en bloc resection of gastrointestinal neoplasms and organ preservation, thereby, avoiding surgical treatment. Although small (<2 cm) intramucosal early gastric cancer with undifferentiated-type histology (EGC-UH) without ulceration is included in the expanded criteria for ESD, controversies remain due to different biology and characteristics compared to EGC with differentiated-type histology. The authors previously presented studies about the technical feasibility of ESD for these lesions using a meta-analysis and retrospective multicenter analysis. However, many pitfalls were identified in the interpretation of studies analyzing histologic discrepancy, mixed-type histology, criteria-based analysis of therapeutic outcomes, interpretation of curative resection, and long-term clinical outcomes. In this review, the authors discuss pitfalls in the interpretation of publications on ESD for EGC-UH.

Keyword

Carcinoma; Endoscopic submucosal dissection; Undifferentiated

MeSH Terms

Biology
Gastrointestinal Neoplasms
Humans
Lymph Nodes
Neoplasm Metastasis
Organ Preservation
Retrospective Studies
Stomach Neoplasms*
Ulcer

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