A case of local recurrence and distant metastasis following curative endoscopic submucosal dissection of early gastric cancer.
Currently in Japan, differentiated-type gastric submucosal invasive cancers <500 μm with negative lymphovascular involvement are included in expanded pathological criteria for curative endoscopic treatment. This categorization is based on a retrospective examination of surgical resection cases in which patients suitable for such expanded criteria were determined to have a negligible risk of lymph node metastasis. We performed endoscopic submucosal dissection on a 66-year-old man with early gastric cancer in June 2004, and pathology revealed a well-differentiated adenocarcinoma, 16 × 8 mm in size, minute submucosal invasion depth (100 μm), and negative lymphovascular invasion or ulceration as well as tumor-free margins, so the case was diagnosed as a curative resection. In this case, however, local recurrence and distant metastasis resulted in August 2011. The patient received systemic chemotherapy but died of gastric cancer 23 months after recurrence.
Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan, seabe@ncc.go.jp.
Seiichiro
S
Abe
Ichiro
I
Oda
Takeshi
T
Nakajima
Haruhisa
H
Suzuki
Satoru
S
Nonaka
Shigetaka
S
Yoshinaga
Shigeki
S
Sekine
Hirokazu
H
Taniguchi
Ryoji
R
Kushima
Satoru
S
Iwasa
Yutaka
Y
Saito
Hitoshi
H
Katai
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005753:Gastric Mucosa / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*