Surgical Outcomes and Clinicopathological Characteristics of Patients Who Underwent Potentially Noncurative Endoscopic Resection for Gastric Cancer: A Report of a Single-Center Experience
Background. Standard treatment of early gastric cancer (EGC) after endoscopic resection with risk factors of nodal metastases and incomplete resection is controversial. We investigated optimal management for the patients with potentially noncurative EGC after endoscopic resection. Methods. We retros...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/427405 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832559371075190784 |
|---|---|
| author | Hiroaki Ito Haruhiro Inoue Haruo Ikeda Noriko Odaka Akira Yoshida Hitoshi Satodate Manabu Onimaru Daisuke Takayanagi Esperanza Grace Santi Shin-ei Kudo |
| author_facet | Hiroaki Ito Haruhiro Inoue Haruo Ikeda Noriko Odaka Akira Yoshida Hitoshi Satodate Manabu Onimaru Daisuke Takayanagi Esperanza Grace Santi Shin-ei Kudo |
| author_sort | Hiroaki Ito |
| collection | DOAJ |
| description | Background. Standard treatment of early gastric cancer (EGC) after endoscopic resection with risk factors of nodal metastases and incomplete resection is controversial. We investigated optimal management for the patients with potentially noncurative EGC after endoscopic resection. Methods. We retrospectively examined clinicopathological data and surgical outcomes of all patients with clinically solitary gastric adenocarcinoma who underwent curative surgery after a single peroral endoscopic resection at the Digestive Disease Center of Showa University Northern Yokohama Hospital between April 2001 and December 2012. Fisher's exact test was used for univariate analysis. For multivariate analysis, stepwise multiple linear regression was used to identify independent predictors related to lymph node metastasis and remnant of primary tumor. Results. A total of 41 patients were studied. Four patients (9.8%) had lymph node metastases. Primary tumors remained in 6 patients (14.6%). Only venous invasion was statistically significant to lymph node metastasis (P=0.017). With respect to remnant of the primary tumor, pT1b2 tumor invasion (P=0.015) and horizontal margin (P=0.013) were statistically significant. Conclusions. Surgery with limited lymphadenectomy is recommended for tumors with venous invasion or pT1b2 tumor invasion, and additional endoscopic resection may be allowed for tumors with horizontal involvement. |
| format | Article |
| id | doaj-art-c3989d42dca74c36bcffe5fafa2b2a05 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-c3989d42dca74c36bcffe5fafa2b2a052025-02-03T01:30:12ZengWileyGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/427405427405Surgical Outcomes and Clinicopathological Characteristics of Patients Who Underwent Potentially Noncurative Endoscopic Resection for Gastric Cancer: A Report of a Single-Center ExperienceHiroaki Ito0Haruhiro Inoue1Haruo Ikeda2Noriko Odaka3Akira Yoshida4Hitoshi Satodate5Manabu Onimaru6Daisuke Takayanagi7Esperanza Grace Santi8Shin-ei Kudo9Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanDigestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanDigestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanDigestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanDigestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanDigestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanDigestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanDigestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanDigestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanDigestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, JapanBackground. Standard treatment of early gastric cancer (EGC) after endoscopic resection with risk factors of nodal metastases and incomplete resection is controversial. We investigated optimal management for the patients with potentially noncurative EGC after endoscopic resection. Methods. We retrospectively examined clinicopathological data and surgical outcomes of all patients with clinically solitary gastric adenocarcinoma who underwent curative surgery after a single peroral endoscopic resection at the Digestive Disease Center of Showa University Northern Yokohama Hospital between April 2001 and December 2012. Fisher's exact test was used for univariate analysis. For multivariate analysis, stepwise multiple linear regression was used to identify independent predictors related to lymph node metastasis and remnant of primary tumor. Results. A total of 41 patients were studied. Four patients (9.8%) had lymph node metastases. Primary tumors remained in 6 patients (14.6%). Only venous invasion was statistically significant to lymph node metastasis (P=0.017). With respect to remnant of the primary tumor, pT1b2 tumor invasion (P=0.015) and horizontal margin (P=0.013) were statistically significant. Conclusions. Surgery with limited lymphadenectomy is recommended for tumors with venous invasion or pT1b2 tumor invasion, and additional endoscopic resection may be allowed for tumors with horizontal involvement.http://dx.doi.org/10.1155/2013/427405 |
| spellingShingle | Hiroaki Ito Haruhiro Inoue Haruo Ikeda Noriko Odaka Akira Yoshida Hitoshi Satodate Manabu Onimaru Daisuke Takayanagi Esperanza Grace Santi Shin-ei Kudo Surgical Outcomes and Clinicopathological Characteristics of Patients Who Underwent Potentially Noncurative Endoscopic Resection for Gastric Cancer: A Report of a Single-Center Experience Gastroenterology Research and Practice |
| title | Surgical Outcomes and Clinicopathological Characteristics of Patients Who Underwent Potentially Noncurative Endoscopic Resection for Gastric Cancer: A Report of a Single-Center Experience |
| title_full | Surgical Outcomes and Clinicopathological Characteristics of Patients Who Underwent Potentially Noncurative Endoscopic Resection for Gastric Cancer: A Report of a Single-Center Experience |
| title_fullStr | Surgical Outcomes and Clinicopathological Characteristics of Patients Who Underwent Potentially Noncurative Endoscopic Resection for Gastric Cancer: A Report of a Single-Center Experience |
| title_full_unstemmed | Surgical Outcomes and Clinicopathological Characteristics of Patients Who Underwent Potentially Noncurative Endoscopic Resection for Gastric Cancer: A Report of a Single-Center Experience |
| title_short | Surgical Outcomes and Clinicopathological Characteristics of Patients Who Underwent Potentially Noncurative Endoscopic Resection for Gastric Cancer: A Report of a Single-Center Experience |
| title_sort | surgical outcomes and clinicopathological characteristics of patients who underwent potentially noncurative endoscopic resection for gastric cancer a report of a single center experience |
| url | http://dx.doi.org/10.1155/2013/427405 |
| work_keys_str_mv | AT hiroakiito surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience AT haruhiroinoue surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience AT haruoikeda surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience AT norikoodaka surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience AT akirayoshida surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience AT hitoshisatodate surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience AT manabuonimaru surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience AT daisuketakayanagi surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience AT esperanzagracesanti surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience AT shineikudo surgicaloutcomesandclinicopathologicalcharacteristicsofpatientswhounderwentpotentiallynoncurativeendoscopicresectionforgastriccancerareportofasinglecenterexperience |