Is endoscopic submucosal dissection safe for papillary adenocarcinoma of the stomach?
| Autor: | Geun Am Song, Bong Eun Lee, Joon Hyung Jhi, Hyun Jeong Lee, Hye Kyung Jeon, Do Youn Park, Gwang Ha Kim |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Lymphovascular invasion medicine.medical_treatment Risk Assessment Metastasis Papillary adenocarcinoma Gastrectomy Predictive Value of Tests Risk Factors Stomach Neoplasms Retrospective Study Gastroscopy medicine Humans Endoscopy Digestive System Lymph node Aged Retrospective Studies Aged 80 and over business.industry Dissection Patient Selection Stomach Gastroenterology General Medicine Middle Aged medicine.disease digestive system diseases Surgery Adenocarcinoma Papillary Treatment Outcome medicine.anatomical_structure Lymphatic Metastasis Predictive value of tests Female business |
| Zdroj: | World Journal of Gastroenterology. 21:3944 |
| ISSN: | 1007-9327 |
| Popis: | AIM: To identify the clinicopathological predictors of lymph node (LN) metastasis and evaluate the outcomes of endoscopic submucosal dissection (ESD) in papillary adenocarcinoma-type early gastric cancers (EGCs). METHODS: From January 2005 to May 2013, 49 patients who underwent surgical operation and 24 patients who underwent ESD for papillary adenocarcinoma-type EGC were enrolled to identify clinicopathological characteristics and predictive factors of LN metastasis and to evaluate the outcomes of ESD for papillary adenocarcinoma-type EGC. RESULTS: Most papillary adenocarcinoma-type EGCs were located in the lower third of the stomach and had an elevated macroscopic shape. The overall prevalence of LN metastasis was 18.3% (9/49). The presence of lymphovascular invasion was found to be a predictor of LN metastasis (P = 0.016). According to current indication criteria of ESD, 6 and 11 of the 49 patients had absolute and expanded indications for ESD, respectively. Two patients (11.8%) with expanded indication for ESD had LN metastasis. Of the 24 patients who underwent ESD, 13 (54%) achieved out-of-ESD indication, with 9 of those 13 patients undergoing surgical operation due to non-curative resection. CONCLUSION: The use of ESD should be carefully considered for papillary adenocarcinoma-type EGC with suspected ESD indication after pre-treatment work-up because of the higher frequency of LN metastasis and additional surgeries. |
| Databáze: | OpenAIRE |
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