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01-10-2013

Clinical implication of endoscopic gross appearance in early gastric cancer: revisited

Authors: Da Hyun Jung, Yoo Mi Park, Jie-Hyun Kim, Yong Chan Lee, Young Hoon Youn, Hyojin Park, Sang In Lee, Jong Won Kim, Seung Ho Choi, Woo Jin Hyung, Sung Hoon Noh

Published in: Surgical Endoscopy | Issue 10/2013

Abstract

Background

The macroscopic appearance of early gastric cancer (EGC) is known to reflect its growth patterns. The purpose of this study was to investigate the role of the endoscopic appearance as a predictor of clinical behavior in EGC.

Methods

Between January 2005 and December 2008, 1,845 patients were diagnosed with EGC and underwent surgery. The clinicopathologic characteristics were retrospectively analyzed according to gross appearance. Endoscopic findings were classified by predominant type as elevated, flat, or depressed. Flat and depressed types were categorized together as nonelevated type.

Results

The proportions of elevated, flat, and depressed types were 16.6, 28.6, and 54.8 %. The gross appearance of the elevated type predominantly showed well/moderate differentiation, whereas the flat and depressed types showed signet-ring cells and poor differentiation, respectively. When the elevated and nonelevated types were compared, submucosal invasion, lymphovascular invasion (LVI), and lymph-node metastasis (LNM) were higher in elevated than in nonelevated type. In differentiated EGC, submucosal invasion, LVI, LNM, and multiplicity were significantly higher in the elevated than the nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. In undifferentiated EGC, submucosal invasion, LVI, and perineural invasion were significantly higher in elevated than in nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. However, LNM was not significantly different based on gross appearance in undifferentiated EGC.

Conclusions

Clinical behavior differs according to endoscopic appearance in EGC. The endoscopic appearance of EGC may facilitate prediction of clinical behavior, particularly in differentiated EGC.

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Title: Clinical implication of endoscopic gross appearance in early gastric cancer: revisited
Authors: Da Hyun Jung
Yoo Mi Park
Jie-Hyun Kim
Yong Chan Lee
Young Hoon Youn
Hyojin Park
Sang In Lee
Jong Won Kim
Seung Ho Choi
Woo Jin Hyung
Sung Hoon Noh
Publication date: 01-10-2013
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 10/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-013-2947-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical implication of endoscopic gross appearance in early gastric cancer: revisited

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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