Su1982 Favorable Prognostic Factors in Advanced Gastric Cancer Patients Ineligible for Criteria of the Clinical Trial
| Autor: | Naoki Horikawa, Hiroki Yoshita, Kazuhisa Yabushita, Takashi Kobayashi, Yushi Hasumoto, Yuko Ueda, Haruka Eujinami, Toshiro Sugiyama, Ayumu Hosokawa, Jun Nishikawa, Sohachi Nanjo, Takayuki Ando, Akira Ueda, Kohei Ogawa, Shinya Kajiura |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Hepatology medicine.diagnostic_test Adenoma business.industry Stomach Gastroenterology medicine.disease Early Gastric Cancer Lesion medicine.anatomical_structure Internal medicine parasitic diseases Biopsy Carcinoma Medicine T-stage Adenocarcinoma medicine.symptom business |
| Zdroj: | Gastroenterology. 144:S-524 |
| ISSN: | 0016-5085 |
| DOI: | 10.1016/s0016-5085(13)61945-9 |
| Popis: | Background/Aims: According to Correa's hypothesis, adenoma at stomach plays a role in gastric carcinogenesis as a precursor. Since endoscopic resection including endoscopic submucosal dissection for premaligant or cancerous lesion has been generally accepted as one of treatment options, endoscopist may have a chance to get the pathologic results showing early gastric cancer arising from adenoma (EGC-AFA). However there have been few reports about clinicopathologic characteristics of EGC-AFA. The aim of this study was to evaluate characteristics of EGC-AFA compared to de novo EGC treated by endoscopic resection. Methods: Between January 2008 and December 2011, 1005 EGCs form 981 S-524 AGA Abstracts patients by endoscopic resectionwere enrolled.We retrospectively reviewed clinicopathologic data of 1005 EGC lesions. Among them 161 lesions (16%) were EGC-AFA and 844 (84%) were de novo EGC. Results: There was no significant difference of age, sex, location of tumor, and gross morphology on EGD between two groups. Synchronous cancer was significantly more frequent in EGC-AFA than in de novo EGC (19.3% vs 10.3%, p=0.001). The tumor size of EGC-AFA measured on EGD was significantly larger than that of de novo EGC (16.6±9.9mm vs 14.5±7.3mm, p=0.004). However, there was no significant difference of actual tumor size on pathologic specimen. The frequency of pathologic discrepancy between biopsy specimen and resected one was higher in EGC-AFA than in de novo EGC (36.6% vs 24.2%, p=0.01). In pathologic characteristics, the differentiated type adenocarcinoma has been shown more frequent in EGC-AFA than de novo EGC (95% vs 88%, p= 0.009), and the submucosal invasion according to T stage (T1b) was significantly less frequent in EGC-AFA than in de novo EGC (12.4% vs 18.0%, p=0.001). Conclusion: The observation of co-existence of adenoma and carcinoma in one specimen is not uncommon. Due to association of adenomatous changes around cancerous lesion, misdiagnosis rate at biopy specimen higher in EGC-AFA and the size measurement of EGC-AFA might be exaggerated on EGD examination. The features of more differentiation and less invasiveness would give more favorable prognosis to EGC-AFA. The endoscopist should pay attention on synchronous ormetachronous lesions on follow up endoscopic examinationwhen encountered EGC-AFA. |
| Databáze: | OpenAIRE |
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