title: Expansion of indications for endoscopic treatment of undifferentiated mucosal gastric cancer: analysis of intramucosal spread in resected specimens.
abstract: OBJECTIVE
  The aim of this study was to pathologically investigate the developmental pattern of undifferentiated mucosal gastric cancer and to determine safe surgical margins for curative resection by endoscopic resection.
  
  
  RESULTS
  Intramucosal cancer spread, or the width of the proliferative zone, was pathologically investigated in 47 cases of undifferentiated mucosal gastric cancer of size 20 mm or smaller without ulceration (scars). The 47 cases comprised 40 IIc and 7 IIb cases. The IIc cases consisted of 5 (12.5%) of intermediate-layer type (cancer localized at the intermediate layer of the mucosa), 31 (77.5%) of superficial type, and 4 of whole-layer type (10%). The IIb cases consisted of six of intermediate-layer type (85.7%) and one of superficial type (14.3%). The width of the proliferative zone in the 40 IIc cases ranged from 0 to 2,390 microm (average 605.5 microm). There was no significant correlation between width of proliferative zone and background mucosa. With regard to lesion size, average width was 243.6 microm in cases with longest diameter <or=5 mm, while it was significantly larger (617.1 microm) in cases with diameter >5 mm.
  
  
  CONCLUSIONS
  In endoscopic treatment of undifferentiated mucosal gastric cancer of size 20 mm or smaller without ulceration (scars), the lateral safety margin should be 3 mm or more.
authors: Department of Gastroenterology, Showa University Fujigaoka Hospital, Tokyo, Japan. susumu_mikiko@yahoo.co.jp
authors: Susumu
authors: S
authors: Sawada
authors: Junko
authors: J
authors: Fujisaki
authors: Noriko
authors: N
authors: Yamamoto
authors: You
authors: Y
authors: Kato
authors: Akiyoshi
authors: A
authors: Ishiyama
authors: Nobue
authors: N
authors: Ueki
authors: Toshiaki
authors: T
authors: Hirasawa
authors: Yorimasa
authors: Y
authors: Yamamoto
authors: Tomohiro
authors: T
authors: Tsuchida
authors: Makoto
authors: M
authors: Tatewaki
authors: Etsuo
authors: E
authors: Hoshino
authors: Masahiro
authors: M
authors: Igarashi
authors: Hiroshi
authors: H
authors: Takahashi
authors: Rikiya
authors: R
authors: Fujita
mesh_terms: D000368:Aged; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology* / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009361:Neoplasm Invasiveness; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome