Is the recent WHO histological classification for gastric cancer helpful for application to endoscopic resection?

Yong Hoon Kim, Jie Hyun Kim, Hyun Ki Kim, Hoguen Kim, Yong Chan Lee, Sang Kil Lee, Sung Kwan Shin, Jun Chul Park, Hyun Soo Chung, Jae Jun Park, Young Hoon Youn, Hyojin Park, Sung Hoon Noh, Seung Ho Choi

Research output: Contribution to journalArticle

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Abstract

Background: Endoscopic resection is performed in undifferentiated-type early gastric cancer (UD-EGC), including poorly differentiated (PD) adenocarcinoma and signet ring cell (SRC) carcinoma. We previously found that different approaches are needed for PD adenocarcinoma and SRC carcinoma for curative resection. However, according to the 2010 WHO classification, diffuse-type PD adenocarcinoma and SRC carcinoma are categorized in the “poorly cohesive carcinomas.” Thus, we assessed whether the WHO classification is helpful when endoscopic resection is performed for treatment of UD-EGC. Methods: We analyzed clinicopathological features of 1295 lesions with SRC carcinoma and PD adenocarcinoma treated by open surgery. We recategorized them into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas (SRC carcinoma, diffuse-type PD adenocarcinoma). We also recategorized 176 lesions treated by endoscopic resection into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas. Results: According to the open surgery data, the rates of lymph node metastasis (LNM) and lymphovascular invasion were significantly lower in SRC carcinoma than in diffuse-type and intestinal-type PD adenocarcinomas. The rates of LNM and lymphovascular invasion were significantly higher in diffuse-type PD adenocarcinoma than in SRC carcinoma. Endoscopic resection data showed no recurrence if the carcinoma was curatively resected. However, the commonest cause of noncurative resection was different in SRC carcinoma and PD adenocarcinoma. A positive lateral margin was the commonest cause in SRC carcinoma versus a positive vertical margin in both intestinal-type and diffuse-type PD adenocarcinoma. Conclusions: The clinical behavior differs in diffuse-type PD adenocarcinoma and SRC carcinoma. On the basis of LNM and outcomes of endoscopic resection, the recent WHO classification may not be helpful when endoscopic resection is performed for treatment of UD-EGC.

Original languageEnglish
Pages (from-to)869-875
Number of pages7
JournalGastric Cancer
Volume19
Issue number3
DOIs
Publication statusPublished - 2016 Jul 1

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Signet Ring Cell Carcinoma
Stomach Neoplasms
Adenocarcinoma
Carcinoma
Lymph Nodes
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Kim, Yong Hoon ; Kim, Jie Hyun ; Kim, Hyun Ki ; Kim, Hoguen ; Lee, Yong Chan ; Lee, Sang Kil ; Shin, Sung Kwan ; Park, Jun Chul ; Chung, Hyun Soo ; Park, Jae Jun ; Youn, Young Hoon ; Park, Hyojin ; Noh, Sung Hoon ; Choi, Seung Ho. / Is the recent WHO histological classification for gastric cancer helpful for application to endoscopic resection?. In: Gastric Cancer. 2016 ; Vol. 19, No. 3. pp. 869-875.
@article{dc5bf36592414c5db18b752e8c848dd5,
title = "Is the recent WHO histological classification for gastric cancer helpful for application to endoscopic resection?",
abstract = "Background: Endoscopic resection is performed in undifferentiated-type early gastric cancer (UD-EGC), including poorly differentiated (PD) adenocarcinoma and signet ring cell (SRC) carcinoma. We previously found that different approaches are needed for PD adenocarcinoma and SRC carcinoma for curative resection. However, according to the 2010 WHO classification, diffuse-type PD adenocarcinoma and SRC carcinoma are categorized in the “poorly cohesive carcinomas.” Thus, we assessed whether the WHO classification is helpful when endoscopic resection is performed for treatment of UD-EGC. Methods: We analyzed clinicopathological features of 1295 lesions with SRC carcinoma and PD adenocarcinoma treated by open surgery. We recategorized them into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas (SRC carcinoma, diffuse-type PD adenocarcinoma). We also recategorized 176 lesions treated by endoscopic resection into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas. Results: According to the open surgery data, the rates of lymph node metastasis (LNM) and lymphovascular invasion were significantly lower in SRC carcinoma than in diffuse-type and intestinal-type PD adenocarcinomas. The rates of LNM and lymphovascular invasion were significantly higher in diffuse-type PD adenocarcinoma than in SRC carcinoma. Endoscopic resection data showed no recurrence if the carcinoma was curatively resected. However, the commonest cause of noncurative resection was different in SRC carcinoma and PD adenocarcinoma. A positive lateral margin was the commonest cause in SRC carcinoma versus a positive vertical margin in both intestinal-type and diffuse-type PD adenocarcinoma. Conclusions: The clinical behavior differs in diffuse-type PD adenocarcinoma and SRC carcinoma. On the basis of LNM and outcomes of endoscopic resection, the recent WHO classification may not be helpful when endoscopic resection is performed for treatment of UD-EGC.",
author = "Kim, {Yong Hoon} and Kim, {Jie Hyun} and Kim, {Hyun Ki} and Hoguen Kim and Lee, {Yong Chan} and Lee, {Sang Kil} and Shin, {Sung Kwan} and Park, {Jun Chul} and Chung, {Hyun Soo} and Park, {Jae Jun} and Youn, {Young Hoon} and Hyojin Park and Noh, {Sung Hoon} and Choi, {Seung Ho}",
year = "2016",
month = "7",
day = "1",
doi = "10.1007/s10120-015-0538-4",
language = "English",
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pages = "869--875",
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Kim, YH, Kim, JH, Kim, HK, Kim, H, Lee, YC, Lee, SK, Shin, SK, Park, JC, Chung, HS, Park, JJ, Youn, YH, Park, H, Noh, SH & Choi, SH 2016, 'Is the recent WHO histological classification for gastric cancer helpful for application to endoscopic resection?', Gastric Cancer, vol. 19, no. 3, pp. 869-875. https://doi.org/10.1007/s10120-015-0538-4

Is the recent WHO histological classification for gastric cancer helpful for application to endoscopic resection? / Kim, Yong Hoon; Kim, Jie Hyun; Kim, Hyun Ki; Kim, Hoguen; Lee, Yong Chan; Lee, Sang Kil; Shin, Sung Kwan; Park, Jun Chul; Chung, Hyun Soo; Park, Jae Jun; Youn, Young Hoon; Park, Hyojin; Noh, Sung Hoon; Choi, Seung Ho.

In: Gastric Cancer, Vol. 19, No. 3, 01.07.2016, p. 869-875.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Is the recent WHO histological classification for gastric cancer helpful for application to endoscopic resection?

AU - Kim, Yong Hoon

AU - Kim, Jie Hyun

AU - Kim, Hyun Ki

AU - Kim, Hoguen

AU - Lee, Yong Chan

AU - Lee, Sang Kil

AU - Shin, Sung Kwan

AU - Park, Jun Chul

AU - Chung, Hyun Soo

AU - Park, Jae Jun

AU - Youn, Young Hoon

AU - Park, Hyojin

AU - Noh, Sung Hoon

AU - Choi, Seung Ho

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background: Endoscopic resection is performed in undifferentiated-type early gastric cancer (UD-EGC), including poorly differentiated (PD) adenocarcinoma and signet ring cell (SRC) carcinoma. We previously found that different approaches are needed for PD adenocarcinoma and SRC carcinoma for curative resection. However, according to the 2010 WHO classification, diffuse-type PD adenocarcinoma and SRC carcinoma are categorized in the “poorly cohesive carcinomas.” Thus, we assessed whether the WHO classification is helpful when endoscopic resection is performed for treatment of UD-EGC. Methods: We analyzed clinicopathological features of 1295 lesions with SRC carcinoma and PD adenocarcinoma treated by open surgery. We recategorized them into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas (SRC carcinoma, diffuse-type PD adenocarcinoma). We also recategorized 176 lesions treated by endoscopic resection into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas. Results: According to the open surgery data, the rates of lymph node metastasis (LNM) and lymphovascular invasion were significantly lower in SRC carcinoma than in diffuse-type and intestinal-type PD adenocarcinomas. The rates of LNM and lymphovascular invasion were significantly higher in diffuse-type PD adenocarcinoma than in SRC carcinoma. Endoscopic resection data showed no recurrence if the carcinoma was curatively resected. However, the commonest cause of noncurative resection was different in SRC carcinoma and PD adenocarcinoma. A positive lateral margin was the commonest cause in SRC carcinoma versus a positive vertical margin in both intestinal-type and diffuse-type PD adenocarcinoma. Conclusions: The clinical behavior differs in diffuse-type PD adenocarcinoma and SRC carcinoma. On the basis of LNM and outcomes of endoscopic resection, the recent WHO classification may not be helpful when endoscopic resection is performed for treatment of UD-EGC.

AB - Background: Endoscopic resection is performed in undifferentiated-type early gastric cancer (UD-EGC), including poorly differentiated (PD) adenocarcinoma and signet ring cell (SRC) carcinoma. We previously found that different approaches are needed for PD adenocarcinoma and SRC carcinoma for curative resection. However, according to the 2010 WHO classification, diffuse-type PD adenocarcinoma and SRC carcinoma are categorized in the “poorly cohesive carcinomas.” Thus, we assessed whether the WHO classification is helpful when endoscopic resection is performed for treatment of UD-EGC. Methods: We analyzed clinicopathological features of 1295 lesions with SRC carcinoma and PD adenocarcinoma treated by open surgery. We recategorized them into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas (SRC carcinoma, diffuse-type PD adenocarcinoma). We also recategorized 176 lesions treated by endoscopic resection into intestinal-type PD adenocarcinomas and poorly cohesive carcinomas. Results: According to the open surgery data, the rates of lymph node metastasis (LNM) and lymphovascular invasion were significantly lower in SRC carcinoma than in diffuse-type and intestinal-type PD adenocarcinomas. The rates of LNM and lymphovascular invasion were significantly higher in diffuse-type PD adenocarcinoma than in SRC carcinoma. Endoscopic resection data showed no recurrence if the carcinoma was curatively resected. However, the commonest cause of noncurative resection was different in SRC carcinoma and PD adenocarcinoma. A positive lateral margin was the commonest cause in SRC carcinoma versus a positive vertical margin in both intestinal-type and diffuse-type PD adenocarcinoma. Conclusions: The clinical behavior differs in diffuse-type PD adenocarcinoma and SRC carcinoma. On the basis of LNM and outcomes of endoscopic resection, the recent WHO classification may not be helpful when endoscopic resection is performed for treatment of UD-EGC.

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U2 - 10.1007/s10120-015-0538-4

DO - 10.1007/s10120-015-0538-4

M3 - Article

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AN - SCOPUS:84940562684

VL - 19

SP - 869

EP - 875

JO - Gastric Cancer

JF - Gastric Cancer

SN - 1436-3291

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