title: Is endoscopic resection an acceptable treatment for undifferentiated EGC?
abstract: OBJECTIVE
  Endoscopic resection (ER) is an effective treatment in selected patients with early gastric cancer (EGC). We have evaluated the clinical outcomes of ER in patients with undifferentiated EGCs, including poorly differentiated adenocarcinoma or signet ring cell carcinoma.
  
  
  METHODS
  We retrospectively examined the medical records of 77 patients diagnosed with undifferentiated EGC after ER (EMR for 22 patients and ESD for 56 patients) at a single center.
  
  
  RESULTS
  The mean±SD lesion size was 23.2±14.1mm. The 77 lesions included 65 (84.4%) intramucosal cancers and 12 (15.6%) involving the submucosal layer. Of these 77 patients, 35 underwent curative resection and 42 did not. After a mean follow-up period of 41 months (range, 9-152), local recurrences were observed in four patients (5.2%), all of whom had not undergone curative resection. No patient died of EGC. Univariate analysis showed that tumor involvement of the resection margins (p<0.001) and lymphatic invasion (p=0.003) were significant risk factors for recurrence after ER in undifferentiated EGCs. However, multivariate analysis did not show any significant risk factors.
  
  
  CONCLUSIONS
  ER may be an alternative treatment modality for selected patients with undifferentiated EGCs.
authors.affiliation: Department of Gastroenterology, Inje University, Busan, South Korea.
authors.forename: Jongha
authors.initials: J
authors.lastname: Park
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.forename: Mi-Young
authors.initials: MY
authors.lastname: Kim
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Ho June
authors.initials: HJ
authors.lastname: Song
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018279:Carcinoma, Signet Ring Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery; D005773:Gastroscopy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden