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KMID : 1141820180180040400
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Journal of Gastric Cancer
2018 Volume.18 No. 4 p.400 ~ p.408
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A Single-Center Experience of Endoscopic Resection for Early Gastric Cancer with Lymphoid Stroma
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Lim Hyun
Lee Jeong-Hoon
Park Young-Soo
Na Hee-Kyong
Ahn Ji-Yong
Kim Do-Hoon
Choi Kee-Don
Song Ho-June
Lee Gin-Hyug
Jung Hwoon-Yong
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Abstract
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Purpose: This study aimed to evaluate immediate outcomes and clinical courses of patients with early gastric carcinoma with lymphoid stroma (GCLS) who underwent endoscopic resection.
Materials and Methods: We retrospectively reviewed the medical records of 40 patients (mean age, 56.9 years; 90.0% male) who underwent endoscopic resection and were pathologically diagnosed with GCLS confined to the mucosa or to the submucosa between March 1998 and December 2017.
Results: Forty GCLS lesions in 40 patients were treated using endoscopic resection. Only 4 (10%) patients received diagnosis of GCLS before endoscopic resection. Fourteen (35.0%) lesions were intramucosal cancers and 26 (65.0%) exhibited submucosal invasion. En bloc resection (97.5%) was achieved for all lesions except one, with no significant complications. The complete resection rate was 85.0% (34 of 40 lesions). After endoscopic resection, 17 patients were referred for surgery and underwent gastrectomy with lymph node (LN) dissection because of deep submucosal invasion (n=16) and misclassification as undifferentiated cancer (n=1). No LN metastasis was determined in the specimens obtained during surgery. During a mean follow-up period of 49.7 months for 23 patients without surgical treatment, no regional LN enlargements, distant metastases, or gastric cancer-related deaths were found, although 1 metachronous lesion (undifferentiated adenocarcinoma, follow-up duration: 7 months) was observed.
Conclusions: In patients with early GCLS, endoscopic resection is technically feasible and has favorable clinical outcomes. Therefore, endoscopic resection might represent an alternative treatment modality in patients with early GCLS with a low likelihood of LN metastasis.
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KEYWORD
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Endoscopy, Stomach, Early gastric cancer, Gastric carcinoma with lymphoid stroma
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