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Endoscopic resection for undifferentiated early gastric cancer

 Jie-Hyun Kim  ;  Yong Chan Lee  ;  Hyunki Kim  ;  Kyung Ho Song  ;  Sang Kil Lee  ;  Jae Hee Cheon  ;  Hoguen Kim  ;  Woo Jin Hyung  ;  Sung Hoon Noh  ;  Choong Bai Kim  ;  Jae Bock Chung 
Journal Title
Issue Date
Adenocarcinoma/pathology* ; Adenocarcinoma/surgery* ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Signet Ring Cell/pathology* ; Carcinoma, Signet Ring Cell/surgery* ; Feasibility Studies ; Female ; Gastroscopy* ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery*
BACKGROUND AND OBJECTIVE: Endoscopic resection (ER) has become an important curative option for early gastric cancer (EGC). However, the application of ER for undifferentiated EGC remains controversial. The aim of this study was to evaluate the clinicopathologic outcomes of ER performed in undifferentiated EGC with special reference to histopathologic subtypes to examine the feasibility of ER in undifferentiated EGC. DESIGN AND SETTING: Retrospective, single-center study. PATIENTS: From January 2001 to April 2007, 58 lesions in 58 patients with undifferentiated EGC (17 poorly differentiated adenocarcinoma; 41 signet-ring cell carcinoma) were treated by ER at Severance Hospital, Seoul, Korea. MAIN OUTCOME MEASUREMENTS: The therapeutic efficacy of ER was assessed according to en bloc resection, histologic complete resection (CR), lateral or vertical cut end-positive (including submucosal invasion), and recurrence rates in 3- to 65-month follow-up periods. RESULTS: The en bloc resection and CR rates were 84.5% and 67.2%, respectively. The en bloc and CR rates in poorly differentiated were 82.4% and 58.8%, whereas those in signet-ring cell were 85.4% and 70.7%, respectively. There were no significant differences between poorly differentiated and signet-ring cell. However, all (100%) of the histologic incomplete resections in poorly differentiated were vertical cut end-positive, whereas 83.3% of these resections in signet-ring cell were lateral cut end-positive. The recurrence rate was 5.1% in CR during the follow-up period. LIMITATIONS: Retrospective, short-term follow-up period. CONCLUSIONS: ER may be a feasible local treatment for undifferentiated EGC if CR can be achieved. However, a different approach is necessary between poorly differentiated and signet-ring cell before ER to prevent incomplete resection.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 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, Choong Bai(김충배)
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Kim, Ho Keun(김호근)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
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, Jae Bock(정재복)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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