Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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A Single-Center Experience of Endoscopic Resection for Early Gastric Cancer with Lymphoid Stroma

  • Lim, Hyun (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jeong Hoon (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Young Soo (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Na, Hee Kyong (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Ji Yong (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Do Hoon (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Kee Don (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Ho June (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Gin Hyug (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Hwoon-Yong (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2018.09.18
  • Accepted : 2018.12.14
  • Published : 2018.12.31
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Abstract

Purpose: This study aimed to evaluate immediate outcomes and clinical courses of patients with early gastric carcinoma with lymphoid stroma (GCLS) who underwent endoscopic resection. Materials and Methods: We retrospectively reviewed the medical records of 40 patients (mean age, 56.9 years; 90.0% male) who underwent endoscopic resection and were pathologically diagnosed with GCLS confined to the mucosa or to the submucosa between March 1998 and December 2017. Results: Forty GCLS lesions in 40 patients were treated using endoscopic resection. Only 4 (10%) patients received diagnosis of GCLS before endoscopic resection. Fourteen (35.0%) lesions were intramucosal cancers and 26 (65.0%) exhibited submucosal invasion. En bloc resection (97.5%) was achieved for all lesions except one, with no significant complications. The complete resection rate was 85.0% (34 of 40 lesions). After endoscopic resection, 17 patients were referred for surgery and underwent gastrectomy with lymph node (LN) dissection because of deep submucosal invasion (n=16) and misclassification as undifferentiated cancer (n=1). No LN metastasis was determined in the specimens obtained during surgery. During a mean follow-up period of 49.7 months for 23 patients without surgical treatment, no regional LN enlargements, distant metastases, or gastric cancer-related deaths were found, although 1 metachronous lesion (undifferentiated adenocarcinoma, follow-up duration: 7 months) was observed. Conclusions: In patients with early GCLS, endoscopic resection is technically feasible and has favorable clinical outcomes. Therefore, endoscopic resection might represent an alternative treatment modality in patients with early GCLS with a low likelihood of LN metastasis.

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References

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