Long-term Outcomes of Undifferentiated-Type Early Gastric Cancer with Positive Horizontal Margins after Endoscopic Resectionopen access
- Authors
- Yang, Hyo-Joon; Lee, Wan-Sik; Lee, Bong Eun; Ahn, Ji Yong; Jang, Jae-Young; Lim, Joo Hyun; Nam, Su Youn; Kim, Jie-Hyun; Min, Byung-Hoon; Joo, Moon Kyung; Park, Jae Myung; Shin, Woon Geon; Lee, Hang Lak; Gweon, Tae-Geun; Park, Moo In; Choi, Jeongmin; Tae, Chung Hyun; Kim, Young-Il; Choi, Il Ju
- Issue Date
- Sep-2021
- Publisher
- EDITORIAL OFFICE GUT & LIVER
- Keywords
- Stomach neoplasms; Undifferentiated-type histology; Endoscopic mucosal resection; Margins of excision; Lymphatic metastasis
- Citation
- GUT AND LIVER, v.15, no.5, pp.723 - 731
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- GUT AND LIVER
- Volume
- 15
- Number
- 5
- Start Page
- 723
- End Page
- 731
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/141170
- DOI
- 10.5009/gnl20291
- ISSN
- 1976-2283
- Abstract
- Background/Aims: This study examined the long-term outcomes of undifferentiated-type early gastric cancer (UD EGC) with positive horizontal margins (HMs) after endoscopic resection (ER) and compared them between additional surgery and nonsurgical management.
Methods: From 2005 to 2015, a total of 1,124 patients with UD EGC underwent ER at 18 tertiary hospitals in Korea. Of them, 92 patients with positive HMs as the only noncurative factor (n=25) or with both positive HMs and tumor size >2 cm (n=67) were included. These patients underwent additional surgery (n=40), underwent additional endoscopic treatment (n=6), or were followed up without further treatment (n=46).
Results: No lymph node (LN) metastasis was found in patients who underwent additional surgery. During a median follow-up of 57.7 months (interquartile range, 27.6 to 68.8 months), no LN or distant metastases or gastric cancer-related deaths occurred in the overall cohort. At baseline, the residual cancer rate was 57.8% (26/45) after additional surgery or ER. The 5-year local recurrence rate was 33.6% among patients who were followed up without additional treatment. The 5-year overall survival rates were 95.0% and 87.8% after additional surgery and nonsurgical management (endoscopic treatment or close follow-up), respectively (log-rank p=0.224). In the multivariate Cox regression analysis, nonsurgical management was not associated with an increased risk of mortality.
Conclusions: UD EGC with positive HMs after ER may have favorable long-term outcomes and a very low risk of LN metastasis. Nonsurgical management may be suggested as an alternative, particularly for patients with old age or chronic illness.
- Files in This Item
-
- Appears in
Collections - 서울 의과대학 > 서울 내과학교실 > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/141170)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.