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Original Article
- The pattern of metachronous recurrence after endoscopic submucosal dissection for gastric adenocarcinoma and dysplasias
- Sunah Suk, Yeon Joo Seo, Dae Young Cheung, Han Hee Lee, Jin Il Kim, Soo-Heon Park
- Clin Endosc 2023;56(4):470-478. Published online April 18, 2023
- DOI: https://doi.org/10.5946/ce.2022.259
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Graphical Abstract
Abstract
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ePub - Background
/Aims: Metachronous recurrence incidences and risk factors following endoscopic submucosal dissection (ESD) for gastric adenocarcinoma and dysplasias were investigated.
Methods
Retrospective review of electronic medical records of patients who underwent gastric ESD at The Catholic University of Korea, Yeouido St. Mary’s Hospital.
Results
A total of 190 subjects were enrolled for analysis during the study period. The mean age was 64.4 years-old and the male sex occupied 73.7%. The mean observation period following ESD was 3.45 years. The annual incidence rate of metachronous gastric neoplasms (MGN) was about 3.96%. The annual incidence rate was 5.36% for the low-grade dysplasia group, 6.47% for the high-grade dysplasia group, and 2.74% for the EGC group. MGN was more frequent in the dysplasia group than in the EGC group (p<0.05). For those with MGN development, the mean time interval from ESD to MGN was 4.1 (±1.8) years. By using the Kaplan–Meier model, the estimated mean MGN free survival time was 9.97 years (95% confidence interval, 8.53–11.40) The histological types of MGN were not related to the primary histology types.
Conclusions
MGN following ESD developed in 3.96% annually and MGN was more frequent in the dysplasia group. The histological types of MGN did not correlate with those of primary neoplasm. -
Citations
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Review
- How to Interpret the Pathological Report before and after Endoscopic Submucosal Dissection of Early Gastric Cancer
- Dae Young Cheung, Soo-Heon Park
- Clin Endosc 2016;49(4):327-331. Published online July 25, 2016
- DOI: https://doi.org/10.5946/ce.2016.082
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Abstract
PDFPubReaderePub
- Possible lymph node metastasis (LNM) and residual cancer are major concerns in endoscopic submucosal dissection (ESD) for early gastric cancer. To reduce the risk of LNM and cancer recurrence, the proper indications for ESD should be considered. Histology, size, depth of invasion, and presence of ulceration should be thoroughly evaluated before proceeding with ESD. However, with incomplete information, discrepancies often arise between the pathological diagnosis based on the forceps biopsy and that based on the totally resected specimen. In addition, the presence of lymphovascular involvement and histological homogeneity can be clarified only after ESD. If the pathological diagnosis changes after ESD, we should reevaluate the curativeness and reformulate the goal of treatment. Additional surgery is a reasonable strategy for non-curative ESD, but a patient’s other health conditions should also be considered. It is simple to read pathological reports before and after ESD, but it can be a complicated art to interpret the report and formulate an optimal approach. In this review, various considerations regarding the pathological diagnosis will be discussed.
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Citations
Citations to this article as recorded by- Application of the convolution neural network in determining the depth of invasion of gastrointestinal cancer: a systematic review and meta-analysis
Ruo Wu, Kaiwen Qin, Yuxin Fang, Yuyuan Xu, Haonan Zhang, Wenhua Li, Xiaobei Luo, Zelong Han, Side Liu, Qingyuan Li
Journal of Gastrointestinal Surgery.2024; 28(4): 538. CrossRef - Comparison of two pathological processing methods for large endoscopic submucosal dissection (ESD) specimens
Zixiang Yu, Dongxian Jiang, Wen Huang, Rongkui Luo, Haixing Wang, Jieakesu Su, Jia Liu, Chen Xu, Yingyong Hou
Journal of Clinical Pathology.2023; 76(11): 757. CrossRef - Establishment and validation of a clinical diagnostic model for gastric low-grade intraepithelial neoplasia
Ting Sun, Xi-quan Ke, Meng Wang, Qi-zhi Wang
Medicine.2023; 102(46): e35515. CrossRef - Artificial Intelligence Assisted Topographic Mapping System for Endoscopic Submucosal Dissection Specimens
Yu Xiao, Zhigang Song, Shuangmei Zou, Yan You, Jie Cui, Shuhao Wang, Calvin Ku, Xi Wu, Xiaowei Xue, Wenqi Han, Weixun Zhou
Frontiers in Medicine.2022;[Epub] CrossRef - Comparative analysis of differences between preoperative endoscopic biopsy and postoperative pathological examination for diagnosis of gastric intraepithelial neoplasia
Yangqing Wu, Jianzhong Sang, Jianbo Zhou, Ying Fang
Journal of International Medical Research.2021;[Epub] CrossRef - Clinical Outcomes of Endoscopic Resection for Low-Grade Dysplasia and High-Grade Dysplasia on Gastric Pretreatment Biopsy: Korea ESD Study Group
Jung Won Jeon, Soo Jin Kim, Jae Young Jang, Sun-Moon Kim, Chul-Hyun Lim, Jae Myung Park, Su Jin Hong, Chan Gyoo Kim, Seong Woo Jeon, Si Hyung Lee, Jae Kyu Sung, Gwang Ho Baik
Gut and Liver.2021; 15(2): 225. CrossRef - Pathology perspective on endoscopic full thickness resection
Ladan Fazlollahi, Helen E. Remotti
Techniques in Gastrointestinal Endoscopy.2019; 21(1): 7. CrossRef - Optimal processing of ESD specimens to avoid pathological artifacts
L. Reggiani Bonetti, R. Manta, M. Manno, R. Conigliaro, G. Missale, G. Bassotti, V. Villanacci
Techniques in Coloproctology.2018; 22(11): 857. CrossRef
- Application of the convolution neural network in determining the depth of invasion of gastrointestinal cancer: a systematic review and meta-analysis
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- 169 Download
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