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Effect of histologic differences between biopsy and final resection on treatment outcomes in early gastric cancer

Authors
 Yonsoo Kim  ;  Hong Jin Yoon  ;  Jie-Hyun Kim  ;  Jaeyoung Chun  ;  Young Hoon Youn  ;  Hyojin Park  ;  In Gyu Kwon  ;  Seung Ho Choi  ;  Sung Hoon Noh 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.34(11) : 5046-5054, 2020-11 
Journal Title
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 
ISSN
 0930-2794 
Issue Date
2020-11
Keywords
Biopsy ; Early gastric cancer ; Endoscopic submucosal dissection ; Gastrectomy ; Histology
Abstract
Background and study aims: Biopsy-based histologic diagnosis is important in determining the treatment strategy for early gastric cancer (EGC). However, there are few studies on how histologic discrepancy may affect patients' treatment outcomes. We aimed to investigate the impact of histopathologic differences between biopsy and final specimens from endoscopic resection (ER) or gastrectomy on treatment outcomes in patients with EGC. We also examined the predictive factors of histologic discrepancy. Patients and methods: We analyzed the data of 1851 patients with EGC treated with ER or gastrectomy. We compared the histology between biopsies and final resected specimens from ER or gastrectomy. We also examined changes in treatment outcomes according to histologic differences. Results: Histologic discrepancy was observed in 11.9% of patients in the ER group and 10.7% of those in the gastrectomy group. In patients treated with ER who showed histologic discrepancy, 80.9% showed differentiated-type EGC (D-EGC) on biopsy but undifferentiated-type-EGC (UD-EGC) after ER, of which 78.9% were non-curative resection. In patients treated with gastrectomy who showed histologic discrepancy, 39% showed UD-EGC on biopsy but showed D-EGC after gastrectomy. A total of these patients had absolute and expanded indications for ER. Moderately differentiated and poorly differentiated adenocarcinoma on biopsy were predictive factors of histologic discrepancy in UD-EGC and D-EGC on final resection, respectively. Conclusions: About 10% of patients showed histologic discrepancy between biopsy and final resection with ER or gastrectomy. Histologic discrepancy can affect treatment outcomes, such as non-curative resection in ER or missing the opportunity for ER in gastrectomy.
Full Text
https://link.springer.com/article/10.1007%2Fs00464-019-07301-z
DOI
10.1007/s00464-019-07301-z
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, In Gyu(권인규) ORCID logo https://orcid.org/0000-0002-1489-467X
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Yoon, Hong Jin(윤홍진) ORCID logo https://orcid.org/0000-0002-4880-3262
Chun, Jaeyoung(천재영) ORCID logo https://orcid.org/0000-0002-4212-0380
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180244
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