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논문 기본 정보

자료유형
학술저널
저자정보
Yang Hyo-Joon (Division of Gastroenterology Department of Internal Medicine and Gastrointestinal Cancer Center Kan) 이완식 (전남대학교) 이봉은 (부산대학교) Ahn Ji Yong (Division of Gastroenterology Department of Internal Medicine Asan Medical Center University of Ulsa) Jang Jae-Young (Department of Internal Medicine Kyung Hee University College of Medicine Seoul Korea) Lim Joo Hyun (Department of Internal Medicine Healthcare Research Institute Healthcare System Gangnam Center Seou) Nam Su Youn (Division of Gastroenterology Kyungpook National University Hospital and School of Medicine Kyungpoo) Kim Jie-Hyun (Division of Gastroenterology Department of Internal Medicine Gangnam Severance Hospital Yonsei Univ) Min Byung-Hoon (Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Kore) Joo Moon Kyung (Department of Internal Medicine Korea University Guro Hospital Korea University College of Medicine) Park Jae Myung (Department of Internal Medicine Seoul St. Mary's Hospital College of Medicine The Catholic Universi) Shin Woon Geon (Department of Internal Medicine Hallym University College of Medicine Seoul Korea) Lee Hang Lak (Division of Gastroenterology Department of Internal Medicine Hanyang University College of Medicine) Gweon Tae-Geun (Division of Gastroenterology Department of Internal Medicine Incheon St. Mary’s Hospital College of) Park Moo In (Department of Internal Medicine Kosin University College of Medicine Busan Korea) Choi Jeongmin (Department of Internal Medicine Sanggye Paik Hospital Inje University College of Medicine Seoul Kor) Tae Chung Hyun (Department of Internal Medicine Ewha Womans University College of Medicine Seoul Korea) Kim Young-Il (Center for Gastric Cancer National Cancer Center Goyang Korea) Choi Il Ju (Center for Gastric Cancer National Cancer Center Goyang Korea)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver 제15권 제5호
발행연도
2021.9
수록면
723 - 731 (9page)
DOI
10.5009/gnl20291

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Background/Aims: This study examined the long-term outcomes of undifferentiated-type early gastric cancer (UD EGC) with positive horizontal margins (HMs) after endoscopic resection (ER) and compared them between additional surgery and nonsurgical management. Methods: From 2005 to 2015, a total of 1,124 patients with UD EGC underwent ER at 18 tertiary hospitals in Korea. Of them, 92 patients with positive HMs as the only noncurative factor (n=25) or with both positive HMs and tumor size >2 cm (n=67) were included. These patients underwent additional surgery (n=40), underwent additional endoscopic treatment (n=6), or were followed up without further treatment (n=46). Results: No lymph node (LN) metastasis was found in patients who underwent additional surgery. During a median follow-up of 57.7 months (interquartile range, 27.6 to 68.8 months), no LN or distant metastases or gastric cancer-related deaths occurred in the overall cohort. At baseline, the residual cancer rate was 57.8% (26/45) after additional surgery or ER. The 5-year local recurrence rate was 33.6% among patients who were followed up without additional treatment. The 5-year overall survival rates were 95.0% and 87.8% after additional surgery and nonsurgical management (endoscopic treatment or close follow-up), respectively (log-rank p=0.224). In the multivariate Cox regression analysis, nonsurgical management was not associated with an increased risk of mortality. Conclusions: UD EGC with positive HMs after ER may have favorable long-term outcomes and a very low risk of LN metastasis. Nonsurgical management may be suggested as an alternative, particularly for patients with old age or chronic illness.
#Stomach neoplasms #Undifferentiated-type histology #Endoscopic mucosal resection #Margins of excision #Lymphatic metastasis

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참고문헌 (21)

참고문헌 신청
Guideline Committee of the Korean Gastric Cancer Association / 2019 / Korean Practice Guideline for Gastric Cancer 2018; Evidence-based, Multi-disciplinary Approach / Journal of Gastric Cancer 19(1):1~48 dbpia Japanese Gastric Cancer Association / 2021 / Japanese gastric cancer treatment guidelines 2018 (5th edition) / Gastric Cancer 24:1~21 google schola Hirasawa T / 2009 / Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer / Gastric Cancer 12:148~152 google schola Gotoda T / 2000 / Incidence of lymph node metastasis from early gastric cancer : estimation with a large number of cases at two large centers / Gastric Cancer 3:219~225 google schola Lee S / 2018 / Long-term outcomes of endoscopic submucosal dissection versus surgery in early gastric cancer meeting expanded indication including undifferentiated-type tumors : a criteria-based analysis / Gastric Cancer 21:490~499 google schola

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