Skip to main content
Top
Published in: Surgical Endoscopy 11/2017

01-11-2017

Location characteristics of early gastric cancer treated with endoscopic submucosal dissection

Authors: Dae Hwan Kang, Cheol Woong Choi, Hyung Wook Kim, Su Bum Park, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu

Published in: Surgical Endoscopy | Issue 11/2017

Login to get access

Abstract

Background and study aims

The timely detection of early gastric cancer (EGC) is important in performing endoscopic submucosal dissection (ESD). We attempted to determine the location characteristics of regions where EGC is frequently detected and analyzed the EGC characteristics associated with that location.

Methods

We retrospectively reviewed the medical records of patients with EGC treated by ESD between November 2008 and August 2016. We retrospectively investigated and analyzed 647 EGC lesions.

Results

The patients’ mean age was 66.7 ± 10.8 years. The patient population was predominantly male (77.1%, 499/647). A well-to-moderately differentiated carcinoma was observed in 97.2% of patients. The common site of carcinoma occurrence was the lower part of the stomach (the antrum and lower third of body, 89.6%). Among the stomach hemispheres, the lesser curvature side was the most frequent site of EGC (43.9%). The posterior side of EGC was more frequent than anterior side of EGC (20.4 vs. 15.6%, respectively). Submucosal invasive EGC was more frequent in the mid-to-upper parts of stomach than lower part of stomach (odds ratio 1.919; confidence interval 1.014–3.623; p = 0.045).

Conclusions

Most EGCs that are resectable with ESD were found in the lower part and in the lesser curvature of the stomach. The submucosal invasive EGC was more frequent in the mid-to-upper part of stomach.
Literature
1.
go back to reference Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90CrossRefPubMed Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90CrossRefPubMed
2.
go back to reference Gotoda T, Yanagisawa A, Sasako M, Ono H, Nakanishi Y, Shimoda T, Kato Y (2000) Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 3:219–225CrossRefPubMed Gotoda T, Yanagisawa A, Sasako M, Ono H, Nakanishi Y, Shimoda T, Kato Y (2000) Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 3:219–225CrossRefPubMed
3.
go back to reference Ahn HS, Lee HJ, Hahn S, Kim WH, Lee KU, Sano T, Edge SB, Yang HK (2010) Evaluation of the seventh American Joint Committee on Cancer/International Union Against Cancer Classification of gastric adenocarcinoma in comparison with the sixth classification. Cancer 116:5592–5598CrossRefPubMed Ahn HS, Lee HJ, Hahn S, Kim WH, Lee KU, Sano T, Edge SB, Yang HK (2010) Evaluation of the seventh American Joint Committee on Cancer/International Union Against Cancer Classification of gastric adenocarcinoma in comparison with the sixth classification. Cancer 116:5592–5598CrossRefPubMed
4.
go back to reference Japanese Gastric Cancer A (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 14:101–112CrossRef Japanese Gastric Cancer A (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 14:101–112CrossRef
5.
go back to reference Kim YI, Kim YW, Choi IJ, Kim CG, Lee JY, Cho SJ, Eom BW, Yoon HM, Ryu KW, Kook MC (2015) Long-term survival after endoscopic resection versus surgery in early gastric cancers. Endoscopy 47:293–301CrossRefPubMed Kim YI, Kim YW, Choi IJ, Kim CG, Lee JY, Cho SJ, Eom BW, Yoon HM, Ryu KW, Kook MC (2015) Long-term survival after endoscopic resection versus surgery in early gastric cancers. Endoscopy 47:293–301CrossRefPubMed
6.
go back to reference Adami HO, Day NE, Trichopoulos D, Willett WC (2001) Primary and secondary prevention in the reduction of cancer morbidity and mortality. Eur J Cancer 37(Suppl 8):S118–S127CrossRefPubMed Adami HO, Day NE, Trichopoulos D, Willett WC (2001) Primary and secondary prevention in the reduction of cancer morbidity and mortality. Eur J Cancer 37(Suppl 8):S118–S127CrossRefPubMed
7.
go back to reference Lee WC (2006) Breast, stomach and colorectal cancer screening in Korea. J Med Screen 13(Suppl 1):S20–S22PubMed Lee WC (2006) Breast, stomach and colorectal cancer screening in Korea. J Med Screen 13(Suppl 1):S20–S22PubMed
8.
go back to reference Jeong O, Park YK (2011) Clinicopathological features and surgical treatment of gastric cancer in South Korea: the results of 2009 nationwide survey on surgically treated gastric cancer patients. J Gastric Cancer 11:69–77CrossRefPubMedPubMedCentral Jeong O, Park YK (2011) Clinicopathological features and surgical treatment of gastric cancer in South Korea: the results of 2009 nationwide survey on surgically treated gastric cancer patients. J Gastric Cancer 11:69–77CrossRefPubMedPubMedCentral
9.
go back to reference Japanese Gastric Cancer A (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef Japanese Gastric Cancer A (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef
10.
go back to reference Lee JH, Kim JG, Jung HK, Kim JH, Jeong WK, Jeon TJ, Kim JM, Kim YI, Ryu KW, Kong SH, Kim HI, Jung HY, Kim YS, Zang DY, Cho JY, Park JO, Lim DH, Jung ES, Ahn HS, Kim HJ (2014) Clinical practice guidelines for gastric cancer in Korea: an evidence-based approach. J Gastric Cancer 14:87–104CrossRefPubMedPubMedCentral Lee JH, Kim JG, Jung HK, Kim JH, Jeong WK, Jeon TJ, Kim JM, Kim YI, Ryu KW, Kong SH, Kim HI, Jung HY, Kim YS, Zang DY, Cho JY, Park JO, Lim DH, Jung ES, Ahn HS, Kim HJ (2014) Clinical practice guidelines for gastric cancer in Korea: an evidence-based approach. J Gastric Cancer 14:87–104CrossRefPubMedPubMedCentral
11.
go back to reference Choi CW, Kim HW, Shin DH, Kang DH, Hong YM, Park JH, Park SB, Cho M, Lee JH (2014) The risk factors for discrepancy after endoscopic submucosal dissection of gastric category 3 lesion (low grade dysplasia). Dig Dis Sci 59:421–427CrossRefPubMed Choi CW, Kim HW, Shin DH, Kang DH, Hong YM, Park JH, Park SB, Cho M, Lee JH (2014) The risk factors for discrepancy after endoscopic submucosal dissection of gastric category 3 lesion (low grade dysplasia). Dig Dis Sci 59:421–427CrossRefPubMed
12.
go back to reference Inoue H, Kashida H, Kudo S, Sasako M, Shimoda T, Watanabe H, Yoshida S, Guelrud M, Lightdale CJ, Wang K, Riddell RH (2003) The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 58:S3–S43CrossRef Inoue H, Kashida H, Kudo S, Sasako M, Shimoda T, Watanabe H, Yoshida S, Guelrud M, Lightdale CJ, Wang K, Riddell RH (2003) The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 58:S3–S43CrossRef
13.
go back to reference Shimizu S, Tada M, Kawai K (1995) Early gastric cancer: its surveillance and natural course. Endoscopy 27:27–31CrossRefPubMed Shimizu S, Tada M, Kawai K (1995) Early gastric cancer: its surveillance and natural course. Endoscopy 27:27–31CrossRefPubMed
15.
go back to reference Gotoda T, Uedo N, Yoshinaga S, Tanuma T, Morita Y, Doyama H, Aso A, Hirasawa T, Yano T, Uchita K, Ho SH, Hsieh PH (2016) Basic principles and practice of gastric cancer screening using high-definition white-light gastroscopy: eyes can only see what the brain knows. Dig Endosc 28(Suppl 1):2–15CrossRefPubMed Gotoda T, Uedo N, Yoshinaga S, Tanuma T, Morita Y, Doyama H, Aso A, Hirasawa T, Yano T, Uchita K, Ho SH, Hsieh PH (2016) Basic principles and practice of gastric cancer screening using high-definition white-light gastroscopy: eyes can only see what the brain knows. Dig Endosc 28(Suppl 1):2–15CrossRefPubMed
16.
go back to reference Correa P (1988) A human model of gastric carcinogenesis. Cancer Res 48:3554–3560PubMed Correa P (1988) A human model of gastric carcinogenesis. Cancer Res 48:3554–3560PubMed
17.
go back to reference Kimura K, Satoh K, Ido K, Taniguchi Y, Takimoto T, Takemoto T (1996) Gastritis in the Japanese stomach. Scand J Gastroenterol Suppl 214:17–20 (discussion 21–13) CrossRefPubMed Kimura K, Satoh K, Ido K, Taniguchi Y, Takimoto T, Takemoto T (1996) Gastritis in the Japanese stomach. Scand J Gastroenterol Suppl 214:17–20 (discussion 21–13) CrossRefPubMed
18.
go back to reference Akashi Y, Noguchi T, Nagai K, Kawahara K, Shimada T (2011) Cytoarchitecture of the lamina muscularis mucosae and distribution of the lymphatic vessels in the human stomach. Med Mol Morphol 44:39–45CrossRefPubMed Akashi Y, Noguchi T, Nagai K, Kawahara K, Shimada T (2011) Cytoarchitecture of the lamina muscularis mucosae and distribution of the lymphatic vessels in the human stomach. Med Mol Morphol 44:39–45CrossRefPubMed
19.
go back to reference Park S, Chun HJ, Kwon YD, Keum B, Seo YS, Kim YS, Jeen YT, Um SH, Kim CD, Ryu HS, Lee JH, Chae YS (2008) Stretching causes extensive changes of gastric submucosa: Is it acceptable to define 500 microm as the safe margin? Gut liver 2:199–204CrossRefPubMedPubMedCentral Park S, Chun HJ, Kwon YD, Keum B, Seo YS, Kim YS, Jeen YT, Um SH, Kim CD, Ryu HS, Lee JH, Chae YS (2008) Stretching causes extensive changes of gastric submucosa: Is it acceptable to define 500 microm as the safe margin? Gut liver 2:199–204CrossRefPubMedPubMedCentral
20.
go back to reference Okada K, Fujisaki J, Yoshida T, Ishikawa H, Suganuma T, Kasuga A, Omae M, Kubota M, Ishiyama A, Hirasawa T, Chino A, Inamori M, Yamamoto Y, Yamamoto N, Tsuchida T, Tamegai Y, Nakajima A, Hoshino E, Igarashi M (2012) Long-term outcomes of endoscopic submucosal dissection for undifferentiated-type early gastric cancer. Endoscopy 44:122–127CrossRefPubMed Okada K, Fujisaki J, Yoshida T, Ishikawa H, Suganuma T, Kasuga A, Omae M, Kubota M, Ishiyama A, Hirasawa T, Chino A, Inamori M, Yamamoto Y, Yamamoto N, Tsuchida T, Tamegai Y, Nakajima A, Hoshino E, Igarashi M (2012) Long-term outcomes of endoscopic submucosal dissection for undifferentiated-type early gastric cancer. Endoscopy 44:122–127CrossRefPubMed
21.
go back to reference An JY, Baik YH, Choi MG, Noh JH, Sohn TS, Kim S (2007) Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg 246:749–753CrossRefPubMed An JY, Baik YH, Choi MG, Noh JH, Sohn TS, Kim S (2007) Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg 246:749–753CrossRefPubMed
22.
go back to reference Ahn JY, Jung HY, Choi KD, Choi JY, Kim MY, Lee JH, Choi KS, Kim DH, Song HJ, Lee GH, Kim JH, Park YS (2011) Endoscopic and oncologic outcomes after endoscopic resection for early gastric cancer: 1370 cases of absolute and extended indications. Gastrointest Endosc 74:485–493CrossRefPubMed Ahn JY, Jung HY, Choi KD, Choi JY, Kim MY, Lee JH, Choi KS, Kim DH, Song HJ, Lee GH, Kim JH, Park YS (2011) Endoscopic and oncologic outcomes after endoscopic resection for early gastric cancer: 1370 cases of absolute and extended indications. Gastrointest Endosc 74:485–493CrossRefPubMed
23.
go back to reference Kim HH, Han SU, Kim MC, Hyung WJ, Kim W, Lee HJ, Ryu SW, Cho GS, Song KY, Ryu SY (2014) Long-term results of laparoscopic gastrectomy for gastric cancer: a large-scale case-control and case-matched Korean multicenter study. J Clin Oncol 32:627–633CrossRefPubMed Kim HH, Han SU, Kim MC, Hyung WJ, Kim W, Lee HJ, Ryu SW, Cho GS, Song KY, Ryu SY (2014) Long-term results of laparoscopic gastrectomy for gastric cancer: a large-scale case-control and case-matched Korean multicenter study. J Clin Oncol 32:627–633CrossRefPubMed
24.
go back to reference Ichikawa D, Komatsu S, Kosuga T, Konishi H, Okamoto K, Shiozaki A, Fujiwara H, Otsuji E (2015) Clinicopathological characteristics of clinical early gastric cancer in the upper-third stomach. World J Gastroenterol 21:12851–12856CrossRefPubMedPubMedCentral Ichikawa D, Komatsu S, Kosuga T, Konishi H, Okamoto K, Shiozaki A, Fujiwara H, Otsuji E (2015) Clinicopathological characteristics of clinical early gastric cancer in the upper-third stomach. World J Gastroenterol 21:12851–12856CrossRefPubMedPubMedCentral
Metadata
Title
Location characteristics of early gastric cancer treated with endoscopic submucosal dissection
Authors
Dae Hwan Kang
Cheol Woong Choi
Hyung Wook Kim
Su Bum Park
Su Jin Kim
Hyeong Seok Nam
Dae Gon Ryu
Publication date
01-11-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5534-9

Other articles of this Issue 11/2017

Surgical Endoscopy 11/2017 Go to the issue