A Single-Center Experience of Endoscopic Resection for Early Gastric Cancer with Lymphoid Stroma.
- Author:
Hyun LIM
1
;
Jeong Hoon LEE
;
Young Soo PARK
;
Hee Kyong NA
;
Ji Yong AHN
;
Do Hoon KIM
;
Kee Don CHOI
;
Ho June SONG
;
Gin Hyug LEE
;
Hwoon Yong JUNG
Author Information
- Publication Type:Original Article
- Keywords: Endoscopy; Stomach; Early gastric cancer; Gastric carcinoma with lymphoid stroma
- MeSH: Adenocarcinoma; Diagnosis; Endoscopy; Follow-Up Studies; Gastrectomy; Humans; Lymph Nodes; Medical Records; Mucous Membrane; Neoplasm Metastasis; Retrospective Studies; Stomach; Stomach Neoplasms*
- From:Journal of Gastric Cancer 2018;18(4):400-408
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
