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• W2074388519 abstract "Although endoscopic submucosal dissection (ESD) is expected to obtain a high complete resection rate of early gastric cancer (EGC), we still experience cases of incomplete resections (piecemeal resection, lateral or vertical margin positive resection). In case of incomplete resections, additional surgical resection should be considered because incomplete resection is one of the most important factor for tumor recurrence. However, it is unclear whether all cases of incomplete resection require additional surgical resection. We performed ESD for 750 cases with EGC at Cancer Institute Hospital between March 2005 to February 2009. We enrolled in this study 57 cases that were incomplete resection after ESD. When a histological finding of incomplete resection case was within the expanded-indications criteria of Japanese Gastric Cancer Association (the JGCA criteria). (1;differentiated mucosal cancer without ulceration and regardless of size, 2; differentiated mucosal cancer with ulceration and lesions≤30mm, 3; differentiated minute submucosal penetrative cancer and lesions≤30mm,4; undifferentiated mucosal cancer without ulceration and lesions≤20mm) we observed the case without additional surgical resection. When a histological finding was beyond the JGCA criteria, we recommended additional surgical resection because of the risk of lymph node metastasis. We examined the long-term outcomes of these incomplete resection cases. In histological findings, 31of 57 cases(54%) were within the JGCA criteria. The causes of incomplete resection were 10 piecemeal resections, 12 lateral margin positive, 9 vertical margin positive respectively.The median follow-up period was 4.1 years, 3 cases showed tumor recurrence. We performed additional ESD, complete resections were achieved for all cases. Only one case died from other disease. In the follow-up period, there was no case required additional surgical resection. On the other hand, 26 of 57 cases(46%) were beyond the JGCA criteria, 22 cases underwent additional surgical resection. There were 5 cases found residual cancers in the resected specimens, and 5 cases with lymph node metastasis. Four cases did not perform additional surgical resection because of advanced age and patient rejection. There was no case died from primary disease. When the histological finding of incomplete resection case after ESD for EGC was beyond the JGCA criteria, we recommend that additional surgical resection is performed for all cases. When the histological finding was within the JGCA criteria, we should consider to observe such case without additional surgical resection. If the tumor recurrence occurs in the follow-up period, we should consider to treat with additional ESD for such lesion." @default.
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• W2074388519 date "2011-04-01" @default.
• W2074388519 modified "2023-10-16" @default.
• W2074388519 title "Sa1643 Study of Incomplete Resection Cases After Endoscopic Submucosal Dissection for Early Gastric Cancer" @default.
• W2074388519 doi "https://doi.org/10.1016/j.gie.2011.03.378" @default.
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