Additive endoscopic resection may be sufficient for patients with a positive lateral margin after endoscopic resection of early gastric cancer

Hae Won Kim, Jie-Hyun Kim, Jun Chul Park, Mi Young Jeon, Yongchan Lee, SangKil Lee, Sung Kwan Shin, Hyun Soo Chung, Sung Hoon Noh, Jong Won Kim, Seung Ho Choi, Jae Jun Park, Young Hoon Youn, HyoJin Park

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and Aims No well-established treatment strategies exist for lateral margin positivity (LM+) alone after endoscopic resection (ER) of early gastric cancer (EGC). Thus, we aimed to clarify a treatment strategy for non-curative resection (non-CR) with LM+ alone after ER in EGC. Methods Among 2065 patients with EGC treated by ER, 76 (3.6%) with only LM+ after non-CR of EGC were reviewed retrospectively. Of these, 28 underwent gastrectomy, 25 underwent argon plasma coagulation (APC), and 23 underwent repeat ER (re-ER). We analyzed the clinicopathologic characteristics of all patients and compared those who underwent additive surgery, APC, or re-ER. Results Of the 76 patients, 28 (36.8%) fulfilled the absolute criteria and 48 (63.2%) the expanded criteria for ER. Among the latter patients, the proportion undergoing additive surgery was 75.0%, higher than that of patients in the former group (P =.014). Residual cancer cells were observed in 70.6% of patients after additive surgery or re-ER. Residual cancer cells were observed significantly more often in patients with undifferentiated-type than in those with differentiated-type EGC (P =.02). However, no lymph node metastasis was observed in any patient after additive surgery. Conclusions Our results suggest that endoscopic treatment may be a sufficient additive therapy for patients with LM+ alone after ER, irrespective of whether the absolute or expanded ER criteria are used. However, as complete ablation of remnant cells cannot be guaranteed, re-ER is a better additive treatment than APC.

Original languageEnglish
Pages (from-to)849-856
Number of pages8
JournalGastrointestinal Endoscopy
Volume86
Issue number5
DOIs
Publication statusPublished - 2017 Nov 1

Fingerprint

Stomach Neoplasms
Argon Plasma Coagulation
Residual Neoplasm
Therapeutics
Gastrectomy
Reoperation
Lymph Nodes
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Kim, Hae Won ; Kim, Jie-Hyun ; Park, Jun Chul ; Jeon, Mi Young ; Lee, Yongchan ; Lee, SangKil ; Shin, Sung Kwan ; Chung, Hyun Soo ; Noh, Sung Hoon ; Kim, Jong Won ; Choi, Seung Ho ; Park, Jae Jun ; Youn, Young Hoon ; Park, HyoJin. / Additive endoscopic resection may be sufficient for patients with a positive lateral margin after endoscopic resection of early gastric cancer. In: Gastrointestinal Endoscopy. 2017 ; Vol. 86, No. 5. pp. 849-856.
@article{37b042897f6546fab9059ae59bd4d6fe,
title = "Additive endoscopic resection may be sufficient for patients with a positive lateral margin after endoscopic resection of early gastric cancer",
abstract = "Background and Aims No well-established treatment strategies exist for lateral margin positivity (LM+) alone after endoscopic resection (ER) of early gastric cancer (EGC). Thus, we aimed to clarify a treatment strategy for non-curative resection (non-CR) with LM+ alone after ER in EGC. Methods Among 2065 patients with EGC treated by ER, 76 (3.6{\%}) with only LM+ after non-CR of EGC were reviewed retrospectively. Of these, 28 underwent gastrectomy, 25 underwent argon plasma coagulation (APC), and 23 underwent repeat ER (re-ER). We analyzed the clinicopathologic characteristics of all patients and compared those who underwent additive surgery, APC, or re-ER. Results Of the 76 patients, 28 (36.8{\%}) fulfilled the absolute criteria and 48 (63.2{\%}) the expanded criteria for ER. Among the latter patients, the proportion undergoing additive surgery was 75.0{\%}, higher than that of patients in the former group (P =.014). Residual cancer cells were observed in 70.6{\%} of patients after additive surgery or re-ER. Residual cancer cells were observed significantly more often in patients with undifferentiated-type than in those with differentiated-type EGC (P =.02). However, no lymph node metastasis was observed in any patient after additive surgery. Conclusions Our results suggest that endoscopic treatment may be a sufficient additive therapy for patients with LM+ alone after ER, irrespective of whether the absolute or expanded ER criteria are used. However, as complete ablation of remnant cells cannot be guaranteed, re-ER is a better additive treatment than APC.",
author = "Kim, {Hae Won} and Jie-Hyun Kim and Park, {Jun Chul} and Jeon, {Mi Young} and Yongchan Lee and SangKil Lee and Shin, {Sung Kwan} and Chung, {Hyun Soo} and Noh, {Sung Hoon} and Kim, {Jong Won} and Choi, {Seung Ho} and Park, {Jae Jun} and Youn, {Young Hoon} and HyoJin Park",
year = "2017",
month = "11",
day = "1",
doi = "10.1016/j.gie.2017.02.037",
language = "English",
volume = "86",
pages = "849--856",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "5",

}

Additive endoscopic resection may be sufficient for patients with a positive lateral margin after endoscopic resection of early gastric cancer. / Kim, Hae Won; Kim, Jie-Hyun; Park, Jun Chul; Jeon, Mi Young; Lee, Yongchan; Lee, SangKil; Shin, Sung Kwan; Chung, Hyun Soo; Noh, Sung Hoon; Kim, Jong Won; Choi, Seung Ho; Park, Jae Jun; Youn, Young Hoon; Park, HyoJin.

In: Gastrointestinal Endoscopy, Vol. 86, No. 5, 01.11.2017, p. 849-856.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Additive endoscopic resection may be sufficient for patients with a positive lateral margin after endoscopic resection of early gastric cancer

AU - Kim, Hae Won

AU - Kim, Jie-Hyun

AU - Park, Jun Chul

AU - Jeon, Mi Young

AU - Lee, Yongchan

AU - Lee, SangKil

AU - Shin, Sung Kwan

AU - Chung, Hyun Soo

AU - Noh, Sung Hoon

AU - Kim, Jong Won

AU - Choi, Seung Ho

AU - Park, Jae Jun

AU - Youn, Young Hoon

AU - Park, HyoJin

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background and Aims No well-established treatment strategies exist for lateral margin positivity (LM+) alone after endoscopic resection (ER) of early gastric cancer (EGC). Thus, we aimed to clarify a treatment strategy for non-curative resection (non-CR) with LM+ alone after ER in EGC. Methods Among 2065 patients with EGC treated by ER, 76 (3.6%) with only LM+ after non-CR of EGC were reviewed retrospectively. Of these, 28 underwent gastrectomy, 25 underwent argon plasma coagulation (APC), and 23 underwent repeat ER (re-ER). We analyzed the clinicopathologic characteristics of all patients and compared those who underwent additive surgery, APC, or re-ER. Results Of the 76 patients, 28 (36.8%) fulfilled the absolute criteria and 48 (63.2%) the expanded criteria for ER. Among the latter patients, the proportion undergoing additive surgery was 75.0%, higher than that of patients in the former group (P =.014). Residual cancer cells were observed in 70.6% of patients after additive surgery or re-ER. Residual cancer cells were observed significantly more often in patients with undifferentiated-type than in those with differentiated-type EGC (P =.02). However, no lymph node metastasis was observed in any patient after additive surgery. Conclusions Our results suggest that endoscopic treatment may be a sufficient additive therapy for patients with LM+ alone after ER, irrespective of whether the absolute or expanded ER criteria are used. However, as complete ablation of remnant cells cannot be guaranteed, re-ER is a better additive treatment than APC.

AB - Background and Aims No well-established treatment strategies exist for lateral margin positivity (LM+) alone after endoscopic resection (ER) of early gastric cancer (EGC). Thus, we aimed to clarify a treatment strategy for non-curative resection (non-CR) with LM+ alone after ER in EGC. Methods Among 2065 patients with EGC treated by ER, 76 (3.6%) with only LM+ after non-CR of EGC were reviewed retrospectively. Of these, 28 underwent gastrectomy, 25 underwent argon plasma coagulation (APC), and 23 underwent repeat ER (re-ER). We analyzed the clinicopathologic characteristics of all patients and compared those who underwent additive surgery, APC, or re-ER. Results Of the 76 patients, 28 (36.8%) fulfilled the absolute criteria and 48 (63.2%) the expanded criteria for ER. Among the latter patients, the proportion undergoing additive surgery was 75.0%, higher than that of patients in the former group (P =.014). Residual cancer cells were observed in 70.6% of patients after additive surgery or re-ER. Residual cancer cells were observed significantly more often in patients with undifferentiated-type than in those with differentiated-type EGC (P =.02). However, no lymph node metastasis was observed in any patient after additive surgery. Conclusions Our results suggest that endoscopic treatment may be a sufficient additive therapy for patients with LM+ alone after ER, irrespective of whether the absolute or expanded ER criteria are used. However, as complete ablation of remnant cells cannot be guaranteed, re-ER is a better additive treatment than APC.

UR - http://www.scopus.com/inward/record.url?scp=85018636404&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018636404&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2017.02.037

DO - 10.1016/j.gie.2017.02.037

M3 - Article

VL - 86

SP - 849

EP - 856

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 5

ER -