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Is gastrectomy mandatory for all residual or recurrent gastric cancer following endoscopic resection? A large-scale Korean multi-center study

Cited 43 time in Web of Science Cited 40 time in Scopus
Authors
Song, Kyo Young; Hyung, Woo Jin; Kim, Hyung Ho; Han, Sang Uk; Cho, Gyu Seok; Ryu, Seung Wan; Lee, Hyuk Joon; Kim, Min Chan
Issue Date
2008-06-04
Publisher
Wiley-Blackwell
Citation
J Surg Oncol. 2008 ;98(1):6-10.
Keywords
AdultAgedAged, 80 and overCarcinoma/*pathology/secondary/*surgeryFemaleFollow-Up Studies*GastrectomyGastroscopyGuideline Adherence/standardsHumansLaparoscopyLymph Node ExcisionLymphatic MetastasisMaleMiddle AgedNeoplasm Recurrence, Local/pathology/*surgeryNeoplasm, Residual/pathology/*surgeryPractice Guidelines as TopicProspective StudiesReoperationStomach Neoplasms/*pathology/*surgeryTreatment Outcome
Abstract
BACKGROUND AND OBJECTIVES: To clarify optimal treatment guidelines for residual or local recurrence after endoscopic resection (ER). METHODS: Eighty-six patients underwent gastrectomy due to incomplete ER and local recurrence after ER. The pathological findings of ER and gastrectomy specimens were analyzed. RESULTS: The cause of gastrectomy was categorized into five groups; submucosal (sm) invasion without margin involvement, positive margin, margin not evaluable, high risk of lymph node metastasis and local recurrence after ER. According to the pathological findings of gastrectomy specimens, remnant cancer and lymph node metastases were found in 56 (65.1%) and in 5 patients (5.8%), respectively. At 10 gastrectomy specimens which were sm invasion without margin involvement, the scattered residual cancer cells were found around the ulcer scar in 2 (20%) patients. In 11 of 44 margin involvement specimens, no residual cancer or lymph node metastasis was found. In patients with local recurrence, mean duration from ER to surgery was 14.8 months, and 19% of patients were found to have sm or deeper depth of invasion. CONCLUSION: Gastrectomy with lymph node dissection should be performed in patients with sm invasion with or without margin involvement. However, minimal approach other than gastrectomy could further be applied to selected patients.
ISSN
1096-9098 (Electronic)
0022-4790 (Print)
Language
English
URI
http://hdl.handle.net/10371/62876
DOI
https://doi.org/10.1002/jso.21074
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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