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World J Gastroenterol. Apr 14, 2014; 20(14): 3938-3949
Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.3938
Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.3938
Table 1 Curability for endoscopic resection of early gastric cancer
Curability criteria | |
Curative resection | En bloc resection, no lateral and vertical margin positivity, no lymphovascular invasion |
Intramucosal cancer, differentiated histology, size ≤ 20 mm, No ulcerative finding | |
Curative resection for expanded indications | En bloc resection, no lateral and vertical margin positivity, no lymphovascular invasion |
Intramucosal cancer, differentiated histology, size > 20 mm, no ulcerative finding | |
Intramucosal cancer, differentiated histology, size ≤ 30 mm, presence of ulcerative finding | |
SM 1 depth of invasion, differentiated histology, size ≤ 30 mm, no ulcerative finding | |
Intramucosal cancer, undifferentiated histology, size ≤ 20 mm, no ulcerative finding | |
Non-curative resection | Any resection that does not satisfy one of the above criteria |
Table 2 Proposed criteria for endoscopic resection of undifferentiated type early gastric cancer
Study | Year | Country | No. of patients with UD-EGC | No. of patients with PD/SRC/MC | LNM in UD-EGC, n (%) | LNM in proposed criteria | Risk factors related to LNM in UD-EGC | Proposed criteria of ER for UD-EGC | |||
Size, mm | Depth of invasion | Ulcer | LVI | ||||||||
Tong et al[53] | 2011 | China | 193 | 81/102/7/31 | 46 (23.8) | 0/72 | Size, depth of invasion, LVI, Histologic type | NS or ≤ 20 | M or SM | NS | No |
Kim et al[54] | 2011 | South Korea | 707 | 288/419/0 | 65 (9.2) | 0/101 | Size, depth of invasion, LVI, Age2 | 153 | M | NS | No |
Li et al[55] | 2010 | China | 108 | 85/16/7 | 16 (14.8) | 0/25 | Size, depth of invasion, LVI | 20 | M | NS | No |
Park et al[56] | 2009 | South Korea | 215 | Only SRC | 17 (7.9) | 0/57 | Depth of invasion, LVI | 25 | SM2 | NS | No |
Kunisaki et al[57] | 2009 | Japan | 573 | 182/378/13 | 74 (12.9) | 0/85 | Size, depth of invasion, LVI | 20 | M | NS | No |
Hirasawa et al[26] | 2009 | Japan | 3843 | NA | 504 (13.1) | 0/310 | Size, depth of invasion, LVI | 20 | M | No | No |
Hanaoka et al[58] | 2009 | Japan | 143 | NA | 35 (24.5) | 0/41 | Size, depth of invasion, LVI, Histologic type | 30 | ≤ 500 μm4 | NS | No5 |
Ye et al[59] | 2008 | South Korea | 591 | 266/316/9 | 79 (13.4) | 0/119 | Size, depth of invasion, LVI | 25 | M | NS | No |
Park et al[60] | 2008 | South Korea | 234 | Only PD | 25 (21.6) | 0/56 | Size, depth of invasion, LVI | 15 | M or ≤ 500 μm | NS | No |
Li et al[61] | 2008 | China | 85 | Only PD | 12 (14.1) | 0/25 | Size, depth of invasion, LVI | 20 | M | NS | No |
Li et al[62] | 2008 | South Korea | 646 | 307/330/9 | 61 (9.4) | 1/201 | Size, depth of invasion, LVI | 20 | M | NS | No |
Ha et al[63] | 2008 | South Korea | 641 | 248/388/5 | 100 (15.6) | 0/77 | Size, depth of invasion, LVI, histologic type | 20 | M | NS | No |
Hyung et al[64] | 2004 | South Korea | 289 | NA | 43 (14.9) | NA | Size, depth of invasion, LVI, histologic type | 15 | M | NS | No |
Abe et al[65] | 2004 | Japan | 175 | 68/104/3 | 32 (18.3) | 0/6 | Size, LVI | 10 | M | NS | No |
Gotoda et al[23] | 2000 | Japan | 2341 | NA | 243 (10.4) | 0/141 | Size, depth of invasion, LVI, histologic type, ulcer, macroscopic type | 20 | M | No | No |
Table 3 Clinical characteristics of representative studies on endoscopic resection for undifferentiated type early gastric cancer
Study | Year | Country | No. of patients with UD-EGC | No. of patients with PD/SRC | Age (yr)1 | Sex (male) | SM invasion | Ulcer | Size (mm)1 | Size > 20 mm |
Kim et al[80] | 2013 | South Korea | 74 | 55/19 | 61.8 ± 12.0 | 40 (54.1) | 16 (21.6) | 11 (14.9) | 19.9 ± 12.5 | 36 (48.6) |
Abe et al[87] | 2013 | Japan | 97 | 18/77/22 | 62.0 (35.0-88.0)3 | 55 (56.7) | 19 (19.6) | 9 (9.3) | 12.03 | 14 (14.4) |
Park et al[88] | 2012 | South Korea | 77 | 47/154 | 60.9 (33.0-82.0) | 49 (63.6) | 12 (15.6) | 4 (5.2) | 23.3 ± 14.0 | 35 (45.5) |
Okada et al[89] | 2012 | Japan | 1035 | 12/91 | 59.0 (34.0-91.0) | 48 (46.6) | 10 (9.7) | 1 (1.0) | 8.0 (1.0-33.0)3 | NA |
Kamada et al[76] | 2012 | Japan | 46 | NA | 65.5 (29.0-90.0) | 24 (52.2) | 7 (15.2) | 1 (2.2) | NA | 8 (17.4) |
Yamamoto et al[90] | 2010 | Japan | 58 | 48/10 | 64.0 (33.0-81.0) | 31 (53.4) | 7 (12.1) | 2 (3.4) | 11.0 (2.0-28.0) | 5 (8.6) |
Kang et al[73] | 2010 | South Korea | 60 | 30/30 | 56.7 ± 10.4 | 31 (51.7) | 17 (28.3) | 17 (28.3) | 26.3 ± 12.9 | 31 (51.7) |
Kim et al[74] | 2009 | South Korea | 58 | 17/41 | 55.0 (26.0-81.0) | 26 (44.8) | NA | 0 (0) | 13.3 ± 6.5 | 4 (6.9) |
Table 4 Short-term outcomes of endoscopic resection for undifferentiated early gastric cancer n (%)
Study | LMP | VMP | LVI | En bloc resection | Complete resection | Curative resection | OP after ER1 | Residual tumor2 | LNM2 | Bleeding | Perforation |
Kim et al[80] | NA | NA | 10 (12.5) | 67 (90.5) | 54 (73.0) | 23 (31.1) | 19/51 (37.3) | NA | NA | 1 (1.4) | 3 (4.1) |
Abe et al[87] | 5 (5.2) | 4 (4.1) | 3 (3.1) | 96 (99.0) | 88 (90.7) | 62 (63.9) | 21/35 (60.0) | 1/21 (4.8) | 2/21 (9.5) | 4 (4.1) | 4 (4.1) |
Park et al[88] | 12 (15.6)3 | 5 (6.5) | 64 (83.1) | NA | 35 (45.5) | 11/42 (26.2) | NA | 0/11 (0.0) | NA | NA | |
Okada et al[89] | 5 (4.9)3 | 2 (2.0) | 102 (99.0) | NA | 85 (82.5) | 10/18 (55.6) | 2/10 (20.0) | 0/10 (0.0) | 9 (8.7) | 1 (1.0) | |
Kamada et al[76] | 5 (10.9) | 4 (8.7) | 4 (8.7) | 42 (91.3) | NA | NA | 5 | 1/5 (20.0) | NA | 2/46 (4.3 | 2 (4.3) |
Yamamoto et al[90] | 1 (1.7) | 0 (0.0) | 2 (3.4) | 57 (98.3) | 52 (89.7) | 46 (79.3) | 8/12 (66.7) | 2/8 (25.0) | 0/8 (0.0) | 5 (8.6) | 2 (3.4) |
Kang et al[73] | 14 (23.3) | 11 (18.3) | 15 (25.0) | 60 (100) | 33 (55.0) | NA | 15/27 (55.6) | 6/15 (40.0) | 2/15 (13.3) | 1 (1.7) | 1 (1.7 |
Kim et al[74] | 10 (52.6) | 9 (47.4) | NA | 49 (84.5) | 39 (67.2) | NA | 9/19 (47.4) | 4/9 (44.4) | 1/9 (11.1) | 8 (13.8) | 1 (1.7) |
- Citation: Shim CN, Lee SK. Endoscopic submucosal dissection for undifferentiated-type early gastric cancer: Do we have enough data to support this? World J Gastroenterol 2014; 20(14): 3938-3949
- URL: https://www.wjgnet.com/1007-9327/full/v20/i14/3938.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i14.3938