The rapeutic outcomes of endoscopic resection of early gastric cancer with undifferentiated-type histology: A korean ESD registry database analysis

Chang Seok Bang, Jae Myung Park, Gwang Ho Baik, Jong Jae Park, Moon Kyung Joo, Jae Young Jang, Seong Woo Jeon, Suck Chei Choi, Jae Kyu Sung, Kwang Bum Cho

Research output: Contribution to journalArticle

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Abstract

Background/Aims: To assess the therapeutic outcomes of endoscopic resection (ER) of early gastric cancer (EGC) with undifferentiated-type histology. Methods: Cases of ER of EGC with undifferentiated-type histology in the Korean endoscopic submucosal dissection (ESD) registry database were identified and reviewed. The immediate outcomes, including en bloc resection, complete resection, and curative resection rates, and long-term outcomes, including recurrence and survival rates, were extracted and analyzed. Results: From 2006 to 2015, 275 EGCs with undifferentiated-type histology from 275 patients were identified. The immediate outcomes were as follows: en bloc resection rate: 92.4%; complete resection rate: 80%; and curative resection rate: 36.4%. Compared to patients with lesions that were beyond the expanded indication, those with expanded indication lesions showed better therapeutic outcomes. There was no difference in immediate outcomes between patients with poorly differentiated adenocarcinoma (PDC) and signet ring cell carcinoma (SRC). However, compared to ER of SRC, ER of PDC had a stronger association with submucosal invasion (41.9% vs. 23.6%, p=0.003). With regard to long-term outcomes, there was no difference between lesions with curative and non-curative resections in the recurrence and mortality rates. These rates also did not differ between PDC and SRC (median follow up: 3.96 years). Conclusions: ER confined to expanded indication lesions can be considered for treatment of EGC with undifferentiated-type histology.

Original languageEnglish
Pages (from-to)569-577
Number of pages9
JournalClinical Endoscopy
Volume50
Issue number6
DOIs
Publication statusPublished - 2017 Nov 1

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Signet Ring Cell Carcinoma
Stomach Neoplasms
Registries
Histology
Databases
Adenocarcinoma
Recurrence
Therapeutics
Survival Rate
Mortality
Endoscopic Mucosal Resection

Keywords

  • Endoscopic mucosal resection
  • Stomach neoplasms
  • Undifferentiated

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

The rapeutic outcomes of endoscopic resection of early gastric cancer with undifferentiated-type histology : A korean ESD registry database analysis. / Bang, Chang Seok; Park, Jae Myung; Baik, Gwang Ho; Park, Jong Jae; Joo, Moon Kyung; Jang, Jae Young; Jeon, Seong Woo; Choi, Suck Chei; Sung, Jae Kyu; Cho, Kwang Bum.

In: Clinical Endoscopy, Vol. 50, No. 6, 01.11.2017, p. 569-577.

Research output: Contribution to journalArticle

Bang, Chang Seok ; Park, Jae Myung ; Baik, Gwang Ho ; Park, Jong Jae ; Joo, Moon Kyung ; Jang, Jae Young ; Jeon, Seong Woo ; Choi, Suck Chei ; Sung, Jae Kyu ; Cho, Kwang Bum. / The rapeutic outcomes of endoscopic resection of early gastric cancer with undifferentiated-type histology : A korean ESD registry database analysis. In: Clinical Endoscopy. 2017 ; Vol. 50, No. 6. pp. 569-577.
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T1 - The rapeutic outcomes of endoscopic resection of early gastric cancer with undifferentiated-type histology

T2 - A korean ESD registry database analysis

AU - Bang, Chang Seok

AU - Park, Jae Myung

AU - Baik, Gwang Ho

AU - Park, Jong Jae

AU - Joo, Moon Kyung

AU - Jang, Jae Young

AU - Jeon, Seong Woo

AU - Choi, Suck Chei

AU - Sung, Jae Kyu

AU - Cho, Kwang Bum

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background/Aims: To assess the therapeutic outcomes of endoscopic resection (ER) of early gastric cancer (EGC) with undifferentiated-type histology. Methods: Cases of ER of EGC with undifferentiated-type histology in the Korean endoscopic submucosal dissection (ESD) registry database were identified and reviewed. The immediate outcomes, including en bloc resection, complete resection, and curative resection rates, and long-term outcomes, including recurrence and survival rates, were extracted and analyzed. Results: From 2006 to 2015, 275 EGCs with undifferentiated-type histology from 275 patients were identified. The immediate outcomes were as follows: en bloc resection rate: 92.4%; complete resection rate: 80%; and curative resection rate: 36.4%. Compared to patients with lesions that were beyond the expanded indication, those with expanded indication lesions showed better therapeutic outcomes. There was no difference in immediate outcomes between patients with poorly differentiated adenocarcinoma (PDC) and signet ring cell carcinoma (SRC). However, compared to ER of SRC, ER of PDC had a stronger association with submucosal invasion (41.9% vs. 23.6%, p=0.003). With regard to long-term outcomes, there was no difference between lesions with curative and non-curative resections in the recurrence and mortality rates. These rates also did not differ between PDC and SRC (median follow up: 3.96 years). Conclusions: ER confined to expanded indication lesions can be considered for treatment of EGC with undifferentiated-type histology.

AB - Background/Aims: To assess the therapeutic outcomes of endoscopic resection (ER) of early gastric cancer (EGC) with undifferentiated-type histology. Methods: Cases of ER of EGC with undifferentiated-type histology in the Korean endoscopic submucosal dissection (ESD) registry database were identified and reviewed. The immediate outcomes, including en bloc resection, complete resection, and curative resection rates, and long-term outcomes, including recurrence and survival rates, were extracted and analyzed. Results: From 2006 to 2015, 275 EGCs with undifferentiated-type histology from 275 patients were identified. The immediate outcomes were as follows: en bloc resection rate: 92.4%; complete resection rate: 80%; and curative resection rate: 36.4%. Compared to patients with lesions that were beyond the expanded indication, those with expanded indication lesions showed better therapeutic outcomes. There was no difference in immediate outcomes between patients with poorly differentiated adenocarcinoma (PDC) and signet ring cell carcinoma (SRC). However, compared to ER of SRC, ER of PDC had a stronger association with submucosal invasion (41.9% vs. 23.6%, p=0.003). With regard to long-term outcomes, there was no difference between lesions with curative and non-curative resections in the recurrence and mortality rates. These rates also did not differ between PDC and SRC (median follow up: 3.96 years). Conclusions: ER confined to expanded indication lesions can be considered for treatment of EGC with undifferentiated-type histology.

KW - Endoscopic mucosal resection

KW - Stomach neoplasms

KW - Undifferentiated

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