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Is the recent WHO histological classification for gastric cancer helpful for application to endoscopic resection?

Authors
 Yong Hoon Kim  ;  Jie-Hyun Kim  ;  HyunKi Kim  ;  Hoguen Kim  ;  Yong Chan Lee  ;  Sang Kil Lee  ;  Sung Kwan Shin  ;  Jun Chul Park  ;  Hyun Soo Chung  ;  Jae Jun Park  ;  Young Hoon Youn  ;  Hyojin Park  ;  Sung Hoon Noh  ;  Seung Ho Choi 
Citation
 GASTRIC CANCER, Vol.19(3) : 869-875, 2016 
Journal Title
GASTRIC CANCER
ISSN
 1436-3291 
Issue Date
2016
MeSH
Adenocarcinoma/classification ; Adenocarcinoma/secondary* ; Adenocarcinoma/surgery ; Carcinoma, Signet Ring Cell/classification ; Carcinoma, Signet Ring Cell/secondary* ; Carcinoma, Signet Ring Cell/surgery ; Endoscopy Female ; Follow-Up Studies ; Gastric Mucosa/pathology* ; Gastroscopy ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Invasiveness ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/classification ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery ; World Health Organization
Keywords
Early gastric cancer ; Endoscopic resection ; Lymph node metastasis ; Undifferentiated
Abstract
BACKGROUND: Endoscopic resection is performed in undifferentiated-type early gastric cancer (UD-EGC), including poorly differentiated (PD) adenocarcinoma and signet ring cell (SRC) carcinoma. We previously found that different approaches are needed for PD adenocarcinoma and SRC carcinoma for curative resection. However, according to the 2010 WHO classification, diffuse-type PD adenocarcinoma and SRC carcinoma are categorized in the "poorly cohesive carcinomas." Thus, we assessed whether the WHO classification is helpful when endoscopic resection is performed for treatment of UD-EGC.
METHODS: We analyzed clinicopathological features of 1295 lesions with SRC carcinoma and PD adenocarcinoma treated by open surgery. We recategorized them into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas (SRC carcinoma, diffuse-type PD adenocarcinoma). We also recategorized 176 lesions treated by endoscopic resection into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas.
RESULTS: According to the open surgery data, the rates of lymph node metastasis (LNM) and lymphovascular invasion were significantly lower in SRC carcinoma than in diffuse-type and intestinal-type PD adenocarcinomas. The rates of LNM and lymphovascular invasion were significantly higher in diffuse-type PD adenocarcinoma than in SRC carcinoma. Endoscopic resection data showed no recurrence if the carcinoma was curatively resected. However, the commonest cause of noncurative resection was different in SRC carcinoma and PD adenocarcinoma. A positive lateral margin was the commonest cause in SRC carcinoma versus a positive vertical margin in both intestinal-type and diffuse-type PD adenocarcinoma.
CONCLUSIONS: The clinical behavior differs in diffuse-type PD adenocarcinoma and SRC carcinoma. On the basis of LNM and outcomes of endoscopic resection, the recent WHO classification may not be helpful when endoscopic resection is performed for treatment of UD-EGC.
Full Text
http://link.springer.com/article/10.1007/s10120-015-0538-4
DOI
10.1007/s10120-015-0538-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Kim, Hogeun(김호근)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Park, Jae Jun(박재준)
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Chung, Hyun Soo(정현수)
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147041
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