Feasibility for the application of expanded endoscopic resection criteria in mucosal undifferentiated gastric cancer.

Autor:	Peng SP; Department of Neurosurgery, Gansu Province People's Hospital, Gansu Province, China., Su QJ; Department of Pathology, The 940th of Joint Logistics Support Force of the Chinese People's Liberation, China., Zheng LJ; Department of Gastroenterology, Gansu Province People's Hospital, Gansu Province, China., Wang Z; Department of Pathology, Gansu Province People's Hospital, Gansu Province, China., Chen X; Department of Pathology, Gansu Province People's Hospital, Gansu Province, China., Liang XQ; Department of Pathology, Gansu Province People's Hospital, Gansu Province, China. Electronic address: liangxq905@163.com.
Jazyk:	angličtina
Zdroj:	Asian journal of surgery [Asian J Surg] 2023 Sep; Vol. 46 (9), pp. 3705-3709. Date of Electronic Publication: 2023 May 18.
DOI:	10.1016/j.asjsur.2023.04.110
Abstrakt:	Background & Aim: The indication of endoscopic submucosal dissection (ESD) for mucosal undifferentiated early gastric cancer (EGC) remains controversial because of risk of lymph node metastasis (LNM). The aim of this study was to identify risk factors for lymph node metastasis (LNM) in mucosal undifferentiated EGC, and further to confirm feasibility of the ESD for the treatment of mucosal undifferentiated EGC. Methods: We retrospectively reviewed data of patients who underwent surgical resection with lymph node dissection of T1a stage primary gastric adenocarcinoma at three medical centers between 2012 and 2022. We evaluated the frequency of lymph node metastasis and the associated risk factors, as well as the lymph node metastasis rate in the expanded indication of mucosal undifferentiated EGC. Results: A total of 100 surgically treated patients with mucosal undifferentiated EGC were enrolled. LNM was irrelevant to the age, tumor size, location, and macroscopic type (all P > 0.05), while it was significantly associated with lymphovascular invasion (LVI, P ＜0.001). And logistic regression analysis showed that the LVI was the only significant risk factors for LNM (OR: 0.34, 95%CI: 0.06-0.204; P ＜0.001). Of 44 mucosal undifferentiated EGC patients satisfying the expanded indication of ESD, 3 patients (6.8%) showed LN metastasis, all of them with undifferentiated cancer without ulceration, less than 2.0 cm in size. Conclusions: Because LNM is present in mucosal undifferentiated EGC patients who satisfied the expanded indication of ESD, ESD cannot be considered a better choice than surgery for all undifferentiated EGC patients. LVI was significant risk factors for LNM in patients with mucosal undifferentiated EGC. (Copyright © 2023 Asian Surgical Association and Taiwan Robotic Surgery Association. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu