Browse > Article
http://dx.doi.org/10.5230/jgc.2010.10.2.49

Expansion of Indication for Endoscopic SD in Early Gastric Cancer  

Kim, Do-Hoon (Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute)
Jung, Hwoon-Yong (Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute)
Publication Information
Journal of Gastric Cancer / v.10, no.2, 2010 , pp. 49-54 More about this Journal
Abstract
Endoscopic resection is now accepted as curative treatment modalities for early gastric cancer without lymph node metastasis. However, based on large-scaled data about the risk of lymph node metastasis in early gastric cancer and as a result of the technical development of endoscopic devices, it was suggested that the criteria for endoscopic resection should be extended. According to the treatment guidelines for gastric cancer in Japan, the extended indications include the following: differentiated-type mucosal cancer without ulceration and greater than 2 cm in diameter, differentiated-type mucosal cancer with ulceration and up to 3 cm in diameter, undifferentiated-type mucosal cancer without ulceration and up to 2 cm in diameter, and, in the absence of lymphovascular invasion, a tumor not deeper than submucosal level 1 (less than $500\;{\mu}m$). In this review, we discuss the evidence of the application of expanded endoscopic indication based on analysis of biologic behavior and data of endoscopic resection.
Keywords
Early gastric cancer; Endoscopic submucosal dissection; Expanded indication;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 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.   DOI   ScienceOn
2 Hyung WJ, Noh SH, Lee JH, Huh JJ, Lah KH, Choi SH, et al. Early gastric carcinoma with signet ring cell histology. Cancer 2002;94:78-83.   DOI   ScienceOn
3 Otsuji E, Yamaguchi T, Sawai K, Takahashi T. Characterization of signet ring cell carcinoma of the stomach. J Surg Oncol 1998;67:216-220.   DOI   ScienceOn
4 Kang HY, Kim SG, Kim JS, Jung HC, Song IS. Clinical outcomes of endoscopic submucosal dissection for undiff eren tiated early gastric cancer. Surg Endosc 2010;24: 509- 516.   DOI   ScienceOn
5 Yasuda K, Shiraishi N, Suematsu T, Yamaguchi K, Adachi Y, Kitano S. Rate of detection of lymph node metastasis is correlated with the depth of submucosal invasion in early stage gastric carcinoma. Cancer 1999;85:2119-2123.   DOI   ScienceOn
6 Ishigami S, Hokita S, Natsugoe S, Tokushige M, Saihara T, Iwashige H, et al. Carcinomatous infiltration into the submucosa as a predictor of lymph node involvement in early gastric cancer. World J Surg 1998;22:1056-1059.   DOI   ScienceOn
7 Gotoda T, Sasako M, Ono H, Katai H, Sano T, Shimoda T. Evaluation of the necessity for gastrectomy with lymph node dissection for patients with submucosal invasive gastric cancer. Br J Surg 2001;88:444-449.   DOI   ScienceOn
8 Oya M, Yao T, Nagai E, Tsuneyoshi M. Metastasizing intramucosal gastric carcinomas. Well diff erentiated type and proliferative activity using proliferative cell nuclear antigen and Ki-67. Cancer 1995;75:926-935.   DOI   ScienceOn
9 Song SY, Park S, Kim S, Son HJ, Rhee JC. Characteristics of intramucosal gastric carcinoma with lymph node metastatic disease. Histopathology 2004;44:437-444.   DOI   ScienceOn
10 Amano Y, Ishihara S, Amano K, Hirakawa K, Adachi K, Fukuda R, et al. An assessment of local curability of endoscopic surgery in early gastric cancer without satisfaction of current therapeutic indications. Endoscopy 1998;30:548- 552.   DOI
11 Kurihara N, Kubota T, Otani Y, Ohgami M, Kumai K, Sugiura H, et al. Lymph node metastasis of early gastric cancer with submucosal invasion. Br J Surg 1998;85:835-839.   DOI   ScienceOn
12 Yamada H, Nihei Z, Yamashita T, Shirota Y, Ichikawa W, Sugihara K. Is lymphadenectomy needed for all submucosal gastric cancers? Eur J Surg 2001;167:199-203.   DOI   ScienceOn
13 Park DJ, Lee HK, Lee HJ, Lee HS, Kim WH, Yang HK, et al. Lymph node metastasis in early gastric cancer with submucosal invasion: feasibility of minimally invasive surgery. World J Gastroenterol 2004;10:3549-3552.
14 Nakahara K, Tsuruta O, Tateishi H, Arima N, Takeda J, Toyonaga A, et al. Extended indication criteria for endoscopic mucosal resection of early gastric cancer with special reference to lymph node metastasis--examination by multivariate analysis. Kurume Med J 2004;51:9-14.   DOI   ScienceOn
15 Tsuchiya A, Kikuchi Y, Ando Y, Yoshida T, Abe R. Lymph node metastases in gastric cancer invading the submucosal layer. Eur J Surg Oncol 1995;21:248-250.   DOI   ScienceOn
16 Nishida T, Tanaka S, Haruma K, Yoshihara M, Sumii K, Kajiyama G. Histologic grade and cellular proliferation at the deepest invasive portion correlate with the high malignancy of submucosal invasive gastric carcinoma. Oncology 1995;52:340-346.   DOI   ScienceOn
17 Maehara Y, Sakaguchi Y, Moriguchi S, Orita H, Korenaga D, Kohnoe S, et al. Signet ring cell carcinoma of the stomach. Cancer 1992;69:1645-1650.   DOI   ScienceOn
18 Sugihara H, Hattori T, Fukuda M, Fujita S. Cell proliferation and diff erentiation in intramucosal and advanced signet ring cell carcinomas of the human stomach. Virchows Arch A Pathol Anat Histopathol 1987;411:117-127.   DOI   ScienceOn
19 Akamatsu T, Katsuyama T. Histochemical demonstration of mucins in the intramucosal laminated structure of human gastric signet ring cell carcinoma and its relation to submucosal invasion. Histochem J 1990;22:416-425.   DOI   ScienceOn
20 Takizawa K, Shimoda T, Nakanishi Y, Taniguchi H, Oda I, Gotoda T. Expanded indication for endoscopic resection from the pathological viewpoint-The possibility of sm invasion by undiff erentiated-type Early Gastric Cancer. Stomach and Intestine 2006;41:9-17.
21 Li C, Kim S, Lai JF, Oh SJ, Hyung WJ, Choi WH, et al. Risk factors for lymph node metastasis in undifferentiated early gastric cancer. Ann Surg Oncol 2008;15:764-769.
22 Kim JH, Lee YC, Kim H, Song KH, Lee SK, Cheon JH, et al. Endoscopic resection for undiff erentiated early gastric cancer. Gastrointest Endosc 2009;69:e1-9.   DOI   ScienceOn
23 Namieno T, Koito K, Higashi T, Sato N, Uchino J. General pattern of lymph node metastasis in early gastric carcinoma. World J Surg 1996;20:996-1000.   DOI   ScienceOn
24 Ohta H, Noguchi Y, Takagi K, Nishi M, Kajitani T, Kato Y. Early gastric carcinoma with special reference to macroscopic classifi cation. Cancer 1987;60:1099-1106.   DOI   ScienceOn
25 Son HJ, Song SY, Kim S, Noh JH, Sohn TS, Kim DS, et al. Characteristics of submucosal gastric carcinoma with lymph node metastatic disease. Histopathology 2005;46:158-165.   DOI   ScienceOn
26 Abe N, Watanabe T, Sugiyama M, Yanagida O, Masaki T, Mori T, et al. Endoscopic treatment or surgery for undiff erentiated early gastric cancer? Am J Surg 2004;188:181-184.   DOI   ScienceOn
27 Nasu J, Nishina T, Hirasaki S, Moriwaki T, Hyodo I, Kurita A, et al. Predictive factors of lymph node metastasis in patients with undifferentiated early gastric cancers. J Clin Gastroenterol 2006;40:412-415.   DOI   ScienceOn
28 Park YD, Chung YJ, Chung HY, Yu W, Bae HI, Jeon SW, et al. Factors related to lymph node metastasis and the feasibility of endoscopic mucosal resection for treating poorly differentiated adenocarcinoma of the stomach. Endoscopy 2008;40:7-10.   DOI   ScienceOn
29 Ye BD, Kim SG, Lee JY, Kim JS, Yang HK, Kim WH, et al. Predictive factors for lymph node metastasis and endoscopic treatment strategies for undiff erentiated early gastric cancer. J Gastroenterol Hepatol 2008;23:46-50.   DOI   ScienceOn
30 Mita T, Shimoda T. Risk factors for lymph node metastasis of submucosal invasive diff erentiated type gastric carcinoma: clinical significance of histological heterogeneity. J Gastroenterol 2001;36:661-668.   DOI   ScienceOn
31 Tajima Y, Yamazaki K, Makino R, Nishino N, Aoki S, Kato M, et al. Gastric and intestinal phenotypic marker expression in early diff erentiated-type tumors of the stomach: clinicopathologic signifi cance and genetic background. Clin Cancer Res 2006;12:6469-6479.   DOI   ScienceOn
32 Kabashima A, Yao T, Maehara Y, Tsuneyoshi M. Relationship between biological behavior and phenotypic expression in undifferentiated-type gastric carcinomas. Gastric Cancer 2005;8:220-227.   DOI   ScienceOn
33 Kunisaki C, Shimada H, Nomura M, Matsuda G, Otsuka Y, Akiyama H. Therapeutic strategy for signet ring cell carcinoma of the stomach. Br J Surg 2004;91:1319-1324.   DOI   ScienceOn
34 Tada M, Murakami A, Karita M, Yanai H, Okita K. Endoscopic resection of early gastric cancer. Endoscopy 1993;25:445-450.   DOI
35 Takekoshi T, Baba Y, Ota H, Kato A, Yanagisawa A, Takagi K, et al. Endoscopic resection of early gastric carcinoma: results of a retrospective analysis of 308 cases. Endoscopy 1994;26:352-358.   DOI   ScienceOn
36 Kim SG. Endoscopic resection of early gastric cancer. Korean J Gastroenterol 2009;54:77-82.   DOI   ScienceOn
37 Kanehara, ed. Treatment Guideline for Gastric Cancer in Japan. 2nd ed. Tokyo. Japanese Gastric Cancer Association, 2004.
38 Soetikno R, Kaltenbach T, Yeh R, Gotoda T. Endoscopic mucosal resection for early cancers of the upper gastrointestinal tract. J Clin Oncol 2005;23:4490-4498.   DOI   ScienceOn
39 Lauren P. Th e two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classifi cation. Acta Pathol Microbiol Scand 1965;64:31-49
40 Nakamura K, Sugano H, Takagi K. Carcinoma of the stomach in incipient phase: its histogenesis and histological appearances. Gann 1968;59:251-258.