Gut Liver.
2024 May;18(3):426-433. 10.5009/gnl230132.
Clinical Outcome of Endoscopic Submucosal Dissection for Papillary Type Early Gastric Cancer: A Multicenter Study
- Shin HD
1 - Bang KB1
- Kang SH2
- Moon HS2
- Sung JK2
- Jeong HY2
- Lee DK3
- Kim KB4
- Kim SM5
- Lee SW6
- Lee DS6
- Cho YS7
- Chung IK7
- Kim JS2
- Affiliations
-
- 1Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
- 2Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
- 3Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
- 4Department of Internal Medicine, Chungbuk National University School of Medicine, Cheongju, Korea
- 5Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
- 6Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 7Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
- KMID: 2555840
- DOI: http://doi.org/10.5009/gnl230132
Abstract
- Background/Aims
Papillary adenocarcinoma is classified to differentiated-type gastric cancer and is indicated for endoscopic submucosal dissection. However, due to its rare nature, there are limited studies on it. The purpose of this study was to determine the outcome of endoscopic submucosal dissection in patients with papillary-type early gastric cancer and to find the risk factors of lymph node metastasis.
Methods
Patients diagnosed with papillary-type early gastric cancer at eight medical centers, who underwent endoscopic submucosal dissection or surgical treatment, were retrospectively reviewed. The clinical results and long-term outcomes of post-endoscopic submucosal dissection were evaluated, and the risk factors of lymph node metastasis in the surgery group were analyzed.
Results
One-hundred and seventy-six patients with papillary-type early gastric cancer were enrolled: 44.9% (n=79) in the surgery group and 55.1% (n=97) in the endoscopic submucosal dissection group. As a result of endoscopic submucosal dissection, the en bloc resection and curative resection rates were 91.8% and 86.6%, respectively. The procedure-related complication rate was 4.1%, and local recurrence occurred in 3.1% of patients. Submucosal invasion (odds ratio, 3.735; 95% confidence interval, 1.026 to 12.177; p=0.047) and lymphovascular invasion (odds ratio, 7.636; 95% confidence interval, 1.730 to 22.857; p=0.004) were the risk factors of lymph node metastasis in papillary-type early gastric cancer patients.
Conclusions
The clinical results of endoscopic submucosal dissection in papillary-type early gastric cancer were relatively favorable, and endoscopic submucosal dissection is considered safe if appropriate indications are confirmed by considering the risk of lymph node metastasis.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Papillary Adenocarcinoma
- Endoscopic Treatment for Early Gastric Cancer
- Recent advances in endoscopic diagnosis and treatment of gastric cancer
- Endoscopic Resection of Early Gastric Cancer in Korea: Recent Results and Future Directions
- Pathological Interpretation of Gastric Tumors in Endoscopic Submucosal Dissection
