| Title |
Can further gastrectomy be avoided in patients with incomplete endoscopic resection?
|
|---|---|
| Published in |
Surgical Endoscopy, April 2017
|
| DOI | 10.1007/s00464-017-5550-9 |
| Pubmed ID | |
| Authors |
Hee Sung Kim, Ji Yong Ahn, Seon Ok Kim, Byung Sik Kim |
| Abstract |
Endoscopic resection (ER) is a widely accepted treatment for patients with early gastric cancer (EGC) with no lymph node metastasis. Occasionally, however, additional surgery is needed due to an incomplete resection. The purpose of this study was to detect clinical factors which might identify patients at greater risk of additional surgery after ER and to suggest an alternative treatment strategy for these patients. This study retrospectively analyzed 350 patients with gastric cancer who underwent radical gastrectomy and lymphadenectomy after ER in a single institution between July 2004 and July 2014. Risk factors for incomplete resection were identified using binary logistic multiple regression tests and a classification and regression tree analysis. Residual cancer cells were found in the remnant stomach or lymph node in 96 patients (27.4%). In multivariate analysis, lymphovascular invasion (p < 0.001, odds ratio [OR] 5.619) and depth of invasion greater than the second submucosal layer (SM2) (p < 0.01, OR 3.224) were independent risk factors for lymph node metastasis. Positive resection margin (p < 0.001, OR 7.565), depth of invasion to mucosa (M) and the first submucosal layer (SM1) (p < 0.001, OR 4.219), and size over 3 cm (p < 0.029, OR 2.306) were significant risk factors for residual tumor in the remnant stomach. Of 106 patients who had invasion of the M or SM1 without lymphatic invasion at the time of ER, residual cancer was found in 53 patients. Of these 53 patients, 50 (94.3%) had residual cancer in the mucosal layer and only one had lymph node metastasis. In patients with EGC with M or SM1 invasion without lymphovascular invasion at the time of ER, who had an incomplete resection, additional endoscopic treatment or close monitoring can be performed instead of additional surgery, especially in patients who are unable to tolerate gastrectomy, for example elderly patients or those with comorbidities. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| France | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 50% |
| Science communicators (journalists, bloggers, editors) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 12 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 12 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 2 | 17% |
| Student > Doctoral Student | 1 | 8% |
| Librarian | 1 | 8% |
| Student > Master | 1 | 8% |
| Student > Ph. D. Student | 1 | 8% |
| Other | 0 | 0% |
| Unknown | 6 | 50% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 7 | 58% |
| Unknown | 5 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 April 2017.
All research outputs
#14,802,093
of 22,965,074 outputs
Outputs from Surgical Endoscopy
#3,543
of 6,091 outputs
Outputs of similar age
#182,053
of 310,317 outputs
Outputs of similar age from Surgical Endoscopy
#87
of 150 outputs
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