Follow-up outcomes of endoscopic resection for early gastric cancer with undifferentiated histology.
The application of endoscopic resection (ER) for undifferentiated-type early gastric cancer (UD-EGC) remains controversial. The aim was to examine long-term outcomes of ER for UD-EGC. Furthermore, we investigated whether long-term outcomes of ER differed between poorly differentiated adenocarcinoma (PD) and signet ring cell carcinoma (SRC).



From 2001 to 2011, 209 lesions in 209 patients with UD-EGC (82 PD; 127 SRC) were treated by ER. We retrospectively assessed the clinical outcomes of ER in 209 patients. The survival rate and disease-free survival rates after ER were evaluated as long-term outcomes.



The en bloc resection and curative resection (CR) rates were 91.4 and 55.0 %, respectively. The en bloc and CR rates in PD were 90.2 and 45.1 %, whereas those in SRC were 92.1 and 61.4 %. For patients with PD who underwent non-curative resections, 51.1 % were vertical-cut end-positive and for those with SRC, 63.3 % were lateral-cut end-positive, a statistically significant difference. In those patients where CR was achieved, no case of local recurrence or distant metastasis was observed during the follow-up period (32.7 ± 22.2 months). The 3- and 5-year survival rates were 99.0 and 98.6 %, with no significant difference between CR patients with SRC and PD.



ER may yield good long-term outcomes for UD-EGC if CR is achieved, with no difference between PD and SRC. However, to increase the current CR rate of ER, stricter criteria for performing ER in UD-EGC may be required.
Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Ku, Seoul, 120-752, Korea.
Jie-Hyun
JH
Kim
Yong Hoon
YH
Kim
Da Hyun
DH
Jung
Han Ho
HH
Jeon
Yong Chan
YC
Lee
Hyuk
H
Lee
Sang Kil
SK
Lee
Jun Chul
JC
Park
Sung Kwan
SK
Shin
Young Hoon
YH
Youn
Hyojin
H
Park
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D004724:Endoscopy / Q000379:methods; D005500:Follow-Up Studies; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome