Endoscopists' view on superficial spreading type of early gastric cancer--endoscopic resection or surgery?
OBJECTIVE
The superficial spreading type of early gastric cancer (EGC) possesses unique features different from other types of EGC. We aimed to elucidate the clinicopathological features of superficial spreading type of EGC.


METHODS
We analyzed 1455 EGC lesions from 1398 patients who had undergone surgical treatment at Samsung Medical Center from 2000 to 2002. Then the clinicopathological features of 224 superficial-spreading EGC lesions (15.4%) was compared to that of 1231 lesions of a common type of EGC.


RESULTS
In the superficial spreading type of EGC, the incidence of undifferentiated type and submucosal invasion were higher than those of common type of EGC (55.4 vs 38.0%, p < .01 and 58.5 vs 37.8%, p < .01, respectively). Lymph node metastasis and lymphovascular invasion were more frequent in superficial spreading type than in common type of EGC (19.2 vs 7.6%, p < .01 and 15.2 vs 7.4%, p < .01, respectively). There was no difference in recurrence rate or 5-year survival rate between the two groups.


CONCLUSIONS
Considering higher risk of submucosal invasion and lymph node metastasis in superficial spreading type, a careful consideration should be done before the application of endoscopic resection to the superficial spreading type of EGC.
Kim
Beom Jin
BJ
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Lee
Jun Haeng
JH
Bae
Sang Soo
SS
Kim
Sang-Jung
SJ
Son
Hee Jung
HJ
Rhee
Poong-Lyul
PL
Kim
Jae J
JJ
Rhee
Jong Chul
JC
Son
Tae Sung
TS
Noh
Jae Hyung
JH
Kim
Sung
S
Kim
Kyung Mee
KM
Park
Chul Keun
CK
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*