Journal of Gastric Cancer

  • 제10권3호
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  • Pages.87-90
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  • 2010
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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The Extended Indications of Endoscopic Submucosal Dissection (ESD) for Early Gastric Cancer Are Thus Not Entirely Safe

  • Lee, Ju-Hee (Department of Surgery, Seoul National University Bundang Hospital) ;
  • Kim, Hyung-Ho (Department of Surgery, Seoul National University College of Medicine)
  • 투고 : 2010.08.19
  • 심사 : 2010.08.23
  • 발행 : 2010.09.30
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초록

Early gastric cancer (EGC) is defined as tumor invasion confined to the mucosa or submucosa, regardless of the presence of regional lymph node metastasis. Lymph node metastasis is the most powerful and important prognostic factor for gastric cancer. Based on the risk of lymph node metastasis in EGC obtained from a large number of surgical cases in Japan, it was suggested that the criteria for endoscopic mucosal resection (EMR) and endoscopic submucosal resection (ESD) as local treatment for EGC might be extended. However, extending the indications for EMR and ESD remains controversial because the long-term outcomes of these procedures have not been fully documented, and there is a risk for lymph node metastasis. Furthermore, current diagnostic imaging techniques are unsatisfactory for accurately predicting metastasis to lymph nodes. Moreover, the long-term results of standard radical gastrectomy including minimally invasive procedures for stage IA have been increasing and have reached 99 to 100%. To determine the true efficacy of endoscopic resection of EGC, we need more evidence of long-term follow-up, standardization of techniques, and pathological interpretation.

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참고문헌

  1. Korean Gastric Cancer Association. 2004 Nationwide gastric cancer report in Korea. J Korean Gastric Cancer Assoc 2007;7:47-54.
  2. Gotoda T, Yanagisawa A, Sasako M, Ono H, Nakanishi Y, Shimoda T, et al. Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 2000;3:219-225. https://doi.org/10.1007/PL00011720
  3. Seto T, Nagawa H, Muto T. Impact of lymph node metastasis on survival with early gastric cancer. World J Surg 1997;21:186-189. https://doi.org/10.1007/s002689900213
  4. Isozaki H, Tanaka N, Okajima K. General and specific prognostic factors of early gastric carcinoma treated with curative surgery. Hepatogastroenterology 1999;46:1800-1808.
  5. Gotoda T, Yamamoto H, Soetikno RM. Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol 2006;41:929-942. https://doi.org/10.1007/s00535-006-1954-3
  6. Gotoda T. Endoscopic resection of early gastric cancer. Gastric Cancer 2007;10:1-11. https://doi.org/10.1007/s10120-006-0408-1
  7. Ishikawa S, Togashi A, Inoue M, Honda S, Nozawa F, Toyama E, et al. Indications for EMR/ESD in cases of early gastric cancer: relationship between histological type, depth of wall invasion, and lymph node metastasis. Gastric Cancer 2007;10:35-38. https://doi.org/10.1007/s10120-006-0407-2
  8. Holscher AH, Drebber U, Mönig SP, Schulte C, Vallböhmer D, Bollschweiler E. Early gastric cancer: lymph node metastasis starts with deep mucosal infi ltration. Ann Surg 2009;250:791-797. https://doi.org/10.1097/SLA.0b013e3181bdd3e4
  9. An JY, Baik YH, Choi MG, Noh JH, Sohn TS, Kim S. Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg 2007;246:749-753. https://doi.org/10.1097/SLA.0b013e31811f3fb7
  10. Jee YS, Hwang SH, Rao J, Park DJ, Kim HH, Lee HJ, et al. Safety of extended endoscopic mucosal resection and endoscopic submucosal dissection following the Japanese Gastric Cancer Association treatment guidelines. Br J Surg 2009;96:1157-1161. https://doi.org/10.1002/bjs.6686
  11. Song KY, Hyung WJ, Kim HH, Han SU, Cho GS, Ryu SW, et al; Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group. Is gastrectomy mandatory for all residual or recurrent gastric cancer following endoscopic resection? A large-scale Korean multi-center study. J Surg Oncol 2008;98:6-10. https://doi.org/10.1002/jso.21074
  12. Kim JJ, Lee JH, Jung HY, Lee GH, Cho JY, Ryu CB, et al. EMR for early gastric cancer in Korea: a multicenter retrospective study. Gastrointest Endosc 2007;66:693-700. https://doi.org/10.1016/j.gie.2007.04.013
  13. Chung IK, Lee JH, Lee SH, Kim SJ, Cho JY, Cho WY, et al. Therapeutic outcomes in 1000 cases of endoscopic submucosal dissection for early gastric neoplasms: Korean ESD Study Group multicenter study. Gastrointest Endosc 2009;69:1228-1235. https://doi.org/10.1016/j.gie.2008.09.027
  14. Isomoto H, Shikuwa S, Yamaguchi N, Fukuda E, Ikeda K, Nishiyama H, et al. Endoscopic submucosal dissection for early gastric cancer: a large-scale feasibility study. Gut 2009;58:331-336. https://doi.org/10.1136/gut.2008.165381
  15. Hwang SH, Park DJ, Jee YS, Kim MC, Kim HH, Lee HJ, et al. Actual 3-year survival aft er laparoscopy-assisted gastrectomy for gastric cancer. Arch Surg 2009;144:559-564. https://doi.org/10.1001/archsurg.2009.110
  16. Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N; Japanese Laparoscopic Surgery Study Group. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 2007;245:68-72. https://doi.org/10.1097/01.sla.0000225364.03133.f8
  17. Cai J, Ikeguchi M, Maeta M, Kaibara N. Micrometastasis in lymph nodes and microinvasion of the muscularis propria in primary lesions of submucosal gastric cancer. Surgery 2000;127:32-39. https://doi.org/10.1067/msy.2000.100881
  18. Nakajo A, Natsugoe S, Ishigami S, Matsumoto M, Nakashima S, Hokita S, et al. Detection and prediction of micrometastasis in the lymph nodes of patients with pN0 gastric cancer. Ann Surg Oncol 2001;8:158-162. https://doi.org/10.1007/s10434-001-0158-6
  19. Maehara Y, Oshiro T, Endo K, Baba H, Oda S, Ichiyoshi Y, et al. Clinical significance of occult micrometastasis in lymph nodes from patients with early gastric cancer who died of recurrence. Surgery 1996;119:397-402. https://doi.org/10.1016/S0039-6060(96)80138-3
  20. Harrison LE, Choe JK, Goldstein M, Meridian A, Kim SH, Clarke K. Prognostic significance of immunohistochemical micrometastasis in node negative gastric cancer patients. J Surg Oncol 2000;73:153-157. https://doi.org/10.1002/(SICI)1096-9098(200003)73:3<153::AID-JSO8>3.0.CO;2-4
  21. Cai J, Ikeguchi M, Tsujitani S, Maeta M, Liu J, Kaibara N. Signifi cant correlation between micrometastasis in the lymph nodes and reduced expression of E-cadherin in early gastric cancer. Gastric Cancer 2001;4:66-74. https://doi.org/10.1007/PL00011726
  22. Cai J, Ikeguchi M, Tsujitani S, MaetaM, Kaibara N. Micrometastasis in lymph nodes of mucosal gastric cancer. Gastric Cancer 2000;3:91-96. https://doi.org/10.1007/PL00011702
  23. Cho JY, Kim YS, Jung IS, Ryu CB, Lee MS, Shim CS, et al. Controversy concerning the cutoff value for depth of submucosal invasion after endoscopic mucosal resection of early gastric cancer. Endoscopy 2006;38:429-430. https://doi.org/10.1055/s-2006-925160
  24. Kim SH, Cho JY, Kim HG, Eun SH, Ko BM, Hong SJ, et al. The value of half stretching method of ESD specimen as interpretation of depth of tumor invasion: interim report. Korean J Gastrointest Endosc 2007;35(suppl 2):117A.
  25. Park DJ, Kim HH, Park YS, Lee HS, Lee WW, Lee HJ, et al. Simultaneous indocyanine green and $^{99m}Tc$-antimony sulfur colloid-guided laparoscopic sentinel basin dissection for gastric cancer. Ann Surg Oncol 2010. [Epub ahead of print]
  26. Ichikura T, Sugasawa H, Sakamoto N, Yaguchi Y, Tsujimoto H, Ono S. Limited gastrectomy with dissection of sentinel node stations for early gastric cancer with negative sentinel node biopsy. Ann Surg 2009;249:942-947. https://doi.org/10.1097/SLA.0b013e3181a77e7e
  27. Adachi Y, Shiraishi N, Kitano S. Modern treatment of early gastric cancer: review of the Japanese experience. Dig Surg 2002;19:333-339. https://doi.org/10.1159/000065829
  28. Kiyama T, Mizutani T, Okuda T, Fujita I, Yamashita N, Ikeda K, et al. Laparoscopic surgery for gastric cancer: 5 years' experience. J Nippon Med Sch 2006;73:214-220. https://doi.org/10.1272/jnms.73.214

피인용 문헌

  1. Endoscopic submucosal dissection for early gastric cancer with undifferentiated-type histology: A meta-analysis vol.21, pp.19, 2010, https://doi.org/10.3748/wjg.v21.i19.6032
  2. Risk factors for lymph node metastasis in mucosal gastric cancer and re-evaluation of endoscopic submucosal dissection vol.91, pp.3, 2010, https://doi.org/10.4174/astr.2016.91.3.118