Clinical outcomes of gastrectomy after incomplete EMR/ESD

Hye Jeong Lee, You-Jin Jang, Jong Han Kim, Sungsoo Park, Seong-Heum Park, Jong Jae Park, Seung Joo Kim, Chong Suk Kim, Young Jae Mok

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: Endoscopic resection is widely accepted as standard treatment for early gastric cancer (EGC) without lymph node metastasis. The procedure is minimally invasive, safe, and convenient. However, surgery is sometimes needed after endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) due to perforation, bleeding, or incomplete resection. We evaluated the role of surgery after incomplete resection. Materials and Methods: We retrospectively studied 29 patients with gastric cancer who underwent a gastrectomy after incomplete EMR/ ESD from 2006 to 2010 at Korea University Hospital. Results: There were 13 incomplete resection cases, seven bleeding cases, three metachronous lesion cases, three recurrence cases, two perforation cases, and one lymphatic invasion case. Among the incomplete resection cases, a positive vertical margin was found in 10, a positive lateral margin in two, and a positive vertical and lateral margin in one case. Most cases (9/13) were diagnosed as mucosal tumors by endoscopic ultrasonography, but only three cases were confirmed as mucosal tumors on final pathology. The positive residual tumor rate was two of 13. The lymph node metastasis rate was three of 13. All lymph node metastasis cases were submucosal tumors with positive lymphatic invasion and no residual tumor in the gastrectomy specimen. No cases of recurrence were observed after curative resection. Conclusions: A gastrectomy is required for patients with incomplete resection following EMR/ESD due to the risk of residual tumor and lymph node metastasis.

Original languageEnglish
Pages (from-to)162-166
Number of pages5
JournalJournal of Gastric Cancer
Volume11
Issue number3
DOIs
Publication statusPublished - 2011 Dec 1

Fingerprint

Gastrectomy
Residual Neoplasm
Lymph Nodes
Neoplasm Metastasis
Stomach Neoplasms
Hemorrhage
Recurrence
Neoplasms
Endosonography
Korea
Endoscopic Mucosal Resection
Pathology

Keywords

  • EMR/ESD
  • Gastrectomy
  • Stomach neoplasms

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Clinical outcomes of gastrectomy after incomplete EMR/ESD. / Lee, Hye Jeong; Jang, You-Jin; Kim, Jong Han; Park, Sungsoo; Park, Seong-Heum; Park, Jong Jae; Kim, Seung Joo; Kim, Chong Suk; Mok, Young Jae.

In: Journal of Gastric Cancer, Vol. 11, No. 3, 01.12.2011, p. 162-166.

Research output: Contribution to journalArticle

@article{1e460eb3d0034b11ac3f6e3d2ffb7bf8,
title = "Clinical outcomes of gastrectomy after incomplete EMR/ESD",
abstract = "Purpose: Endoscopic resection is widely accepted as standard treatment for early gastric cancer (EGC) without lymph node metastasis. The procedure is minimally invasive, safe, and convenient. However, surgery is sometimes needed after endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) due to perforation, bleeding, or incomplete resection. We evaluated the role of surgery after incomplete resection. Materials and Methods: We retrospectively studied 29 patients with gastric cancer who underwent a gastrectomy after incomplete EMR/ ESD from 2006 to 2010 at Korea University Hospital. Results: There were 13 incomplete resection cases, seven bleeding cases, three metachronous lesion cases, three recurrence cases, two perforation cases, and one lymphatic invasion case. Among the incomplete resection cases, a positive vertical margin was found in 10, a positive lateral margin in two, and a positive vertical and lateral margin in one case. Most cases (9/13) were diagnosed as mucosal tumors by endoscopic ultrasonography, but only three cases were confirmed as mucosal tumors on final pathology. The positive residual tumor rate was two of 13. The lymph node metastasis rate was three of 13. All lymph node metastasis cases were submucosal tumors with positive lymphatic invasion and no residual tumor in the gastrectomy specimen. No cases of recurrence were observed after curative resection. Conclusions: A gastrectomy is required for patients with incomplete resection following EMR/ESD due to the risk of residual tumor and lymph node metastasis.",
keywords = "EMR/ESD, Gastrectomy, Stomach neoplasms",
author = "Lee, {Hye Jeong} and You-Jin Jang and Kim, {Jong Han} and Sungsoo Park and Seong-Heum Park and Park, {Jong Jae} and Kim, {Seung Joo} and Kim, {Chong Suk} and Mok, {Young Jae}",
year = "2011",
month = "12",
day = "1",
doi = "10.5230/jgc.2011.11.3.162",
language = "English",
volume = "11",
pages = "162--166",
journal = "Journal of Gastric Cancer",
issn = "2093-582X",
publisher = "Korean Gastric Cancer Association",
number = "3",

}

TY - JOUR

T1 - Clinical outcomes of gastrectomy after incomplete EMR/ESD

AU - Lee, Hye Jeong

AU - Jang, You-Jin

AU - Kim, Jong Han

AU - Park, Sungsoo

AU - Park, Seong-Heum

AU - Park, Jong Jae

AU - Kim, Seung Joo

AU - Kim, Chong Suk

AU - Mok, Young Jae

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Purpose: Endoscopic resection is widely accepted as standard treatment for early gastric cancer (EGC) without lymph node metastasis. The procedure is minimally invasive, safe, and convenient. However, surgery is sometimes needed after endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) due to perforation, bleeding, or incomplete resection. We evaluated the role of surgery after incomplete resection. Materials and Methods: We retrospectively studied 29 patients with gastric cancer who underwent a gastrectomy after incomplete EMR/ ESD from 2006 to 2010 at Korea University Hospital. Results: There were 13 incomplete resection cases, seven bleeding cases, three metachronous lesion cases, three recurrence cases, two perforation cases, and one lymphatic invasion case. Among the incomplete resection cases, a positive vertical margin was found in 10, a positive lateral margin in two, and a positive vertical and lateral margin in one case. Most cases (9/13) were diagnosed as mucosal tumors by endoscopic ultrasonography, but only three cases were confirmed as mucosal tumors on final pathology. The positive residual tumor rate was two of 13. The lymph node metastasis rate was three of 13. All lymph node metastasis cases were submucosal tumors with positive lymphatic invasion and no residual tumor in the gastrectomy specimen. No cases of recurrence were observed after curative resection. Conclusions: A gastrectomy is required for patients with incomplete resection following EMR/ESD due to the risk of residual tumor and lymph node metastasis.

AB - Purpose: Endoscopic resection is widely accepted as standard treatment for early gastric cancer (EGC) without lymph node metastasis. The procedure is minimally invasive, safe, and convenient. However, surgery is sometimes needed after endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) due to perforation, bleeding, or incomplete resection. We evaluated the role of surgery after incomplete resection. Materials and Methods: We retrospectively studied 29 patients with gastric cancer who underwent a gastrectomy after incomplete EMR/ ESD from 2006 to 2010 at Korea University Hospital. Results: There were 13 incomplete resection cases, seven bleeding cases, three metachronous lesion cases, three recurrence cases, two perforation cases, and one lymphatic invasion case. Among the incomplete resection cases, a positive vertical margin was found in 10, a positive lateral margin in two, and a positive vertical and lateral margin in one case. Most cases (9/13) were diagnosed as mucosal tumors by endoscopic ultrasonography, but only three cases were confirmed as mucosal tumors on final pathology. The positive residual tumor rate was two of 13. The lymph node metastasis rate was three of 13. All lymph node metastasis cases were submucosal tumors with positive lymphatic invasion and no residual tumor in the gastrectomy specimen. No cases of recurrence were observed after curative resection. Conclusions: A gastrectomy is required for patients with incomplete resection following EMR/ESD due to the risk of residual tumor and lymph node metastasis.

KW - EMR/ESD

KW - Gastrectomy

KW - Stomach neoplasms

UR - http://www.scopus.com/inward/record.url?scp=84867559051&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867559051&partnerID=8YFLogxK

U2 - 10.5230/jgc.2011.11.3.162

DO - 10.5230/jgc.2011.11.3.162

M3 - Article

C2 - 22076221

AN - SCOPUS:84867559051

VL - 11

SP - 162

EP - 166

JO - Journal of Gastric Cancer

JF - Journal of Gastric Cancer

SN - 2093-582X

IS - 3

ER -