Is endoscopic submucosal dissection safe for papillary adenocarcinoma of the stomach?

作     者：Hyun Jeong Lee Gwang Ha Kim Do Youn Park Bong Eun Lee Hye Kyung Jeon Joon Hyung Jhi Geun Am Song 

作者机构：Department of Internal MedicinePusan National University School of Medicine and Biomedical Research Institute Pusan National University HospitalBusan 602-739South Korea Department of PathologyPusan National University School of MedicineBusan 602-739South Korea 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第13期

页      面：3944-3952页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Grant of the Korea Healthcare Technology R and D Project Ministry of Health and Welfare South Korea No.HI12C1845 

主　　题：Gastric cancer Papillary adenocarcinoma Endoscopic 

摘      要：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 adenocarcinomatype EGC were enrolled to identify clinicopathological characteristics and predictive factors of LN metastasis and to evaluate the outcomes of ESD for papillary adenocarcinoma-type ***: 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.