AI Article Synopsis
- Endoscopic submucosal dissection (ESD) is used for treating early gastric cancer characterized by signet ring cells, but factors affecting treatment success are not well-studied.
- A study analyzed 126 patients to identify factors linked to incomplete tumor removal during ESD, discovering that larger tumor size significantly increases the risk of incomplete resection and underestimation of tumor size during endoscopy.
- The findings suggest that for better outcomes in treating signet ring cell early gastric cancer, larger tumors (especially those 20mm or more) should be removed with a larger margin.
Article Abstract
Background: Endoscopic submucosal dissection is applied in selected cases of signet ring cell early gastric cancer. However, factors related to curability of signet ring cell early gastric cancer with this method have not been fully evaluated. Our aim was to evaluate factors related to incomplete resection in signet ring cell early gastric cancer with endoscopic submucosal dissection.
Methods: A retrospective analysis was performed on a total of 126 consecutive patients with signet ring cell early gastric cancer who had undergone endoscopic submucosal dissection at the Severance Hospital in Korea, between March 2007 and March 2012. The clinical outcomes were reviewed and factors related to incomplete resection were analysed.
Results: Multivariate analysis showed that large tumour size was the only significant factor related to incomplete resection (P=0.006; hazard ratio, 1.040; 95% confidence interval, 1.101-1.084). In addition, large tumour size was the only significant factor related to endoscopic size underestimation (P<0.001; hazard ratio, 1.391; 95% confidence interval, 1.221-1.586). The rate of endoscopic size underestimation was significantly higher in tumours with a size ≥20mm (P<0.001).
Conclusions: To improve the curability of signet ring cell early gastric cancer with endoscopic submucosal dissection, larger tumours (especially tumour with a size ≥20mm) should be resected with a larger margin.
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| http://dx.doi.org/10.1016/j.dld.2014.05.019 | DOI Listing |
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