Sa1583 Repeat Endoscopic Submucosal Dissection (Re-ESD) Is a Safe and Effective Treatment for Locally Recurrent Gastric Cancers

Abstract A case of a 59-year-old male patient with gastric neuroendocrine tumor which was misdiagnosed as adenocarcinoma, is presented. Herein, primary diagnosis was made due to the similarity of endoscopic pictures of both diseases and dues to the inappropriate interpretation of a small biopsy sample. The patient was qualified for endoscopic submucosal dissection. Microscopic examination of whole lesion, supplemented by immmunohistochemical reactions (chromogranin A, synaptophysin, cytokeratins 7 and 20, Ki67) revealed gastric neuroendocrine tumor (NET) G2. The lesson learnt is that to provide effective treatment to the patient, it is necessary to use all available methods to make a proper diagnosis and to distinguish the suspected disease from others with similar features.

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Tu1121 RISK FACTORS FOR NON-CURATIVE RESECTION OF EARLY GASTRIC CANCERS WITH ENDOSCOPIC SUBMUCOSAL DISSECTION

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2019.03.969 ◽

2019 ◽

Vol 89 (6) ◽

pp. AB568

Author(s):

Ping Xu ◽

Guoxin Zhang

Keyword(s):

Risk Factors ◽

Endoscopic Submucosal Dissection ◽

Curative Resection ◽

Gastric Cancers ◽

Submucosal Dissection

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909 Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection in the Treatment of Superficial Gastric Cancers - A Meta-Analysis Update

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000593172.09752.42 ◽

2019 ◽

Vol 114 (1) ◽

pp. S528-S529

Author(s):

Ajai Rajabalan ◽

Vishnu Charan Suresh Kumar ◽

Venkata Suresh Patthipati ◽

Vishnu Mani

Keyword(s):

Endoscopic Submucosal Dissection ◽

Endoscopic Mucosal Resection ◽

Meta Analysis ◽

Gastric Cancers ◽

Mucosal Resection ◽

Submucosal Dissection

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Risk of recurrence when cutting into intramucosal (pT1a) cancer from the cutting-plane side during gastric endoscopic submucosal dissection

Endoscopy ◽

10.1055/a-1173-8575 ◽

2020 ◽

Vol 52 (10) ◽

pp. 833-838

Author(s):

Hiroko Nakahira ◽

Takashi Kanesaka ◽

Noriya Uedo ◽

Masayasu Ohmori ◽

Hiroyoshi Iwagami ◽

...

Keyword(s):

Local Recurrence ◽

Endoscopic Submucosal Dissection ◽

Cutting Plane ◽

Risk Of Recurrence ◽

Gastric Cancers ◽

Submucosal Dissection ◽

Additional Surgery ◽

Risk Factors For Recurrence ◽

Surveillance Endoscopy

Background During endoscopic submucosal dissection (ESD), procedural difficulty and poor visibility of the cutting plane sometimes cause the operator to cut into the lesion from the cutting-plane side, making the vertical margin positive (VM1) or unclear (VMX). In the present study, we evaluated the risk of recurrence of gastric cancer with VM1 /VMX after ESD. Methods In total, 1723 consecutive gastric cancers treated by ESD at Osaka International Cancer Institute from July 2012 to December 2017 were included in this retrospective cohort study. Among them, 231 submucosal or more deeply invasive gastric cancers were excluded because nontechnical factors may contribute to VM1 /VMX in such lesions. To quantify the risk of cutting into cancer from the cutting-plane side during ESD, the proportion of lesions with VM1 /VMX among the pT1a gastric cancers treated by ESD was calculated. The proportion of recurrence among these cases was calculated after exclusion of lesions with positive lymphovascular invasion or a positive horizontal margin in order to eliminate the obvious risk factors for recurrence. Results Among 1492 pT1a gastric cancers treated by ESD, 28 lesions (1.9 %; 95 % confidence interval [CI] 1.3 % – 2.7 %) histologically showed VM1 /VMX. No local recurrence (0.0 %; 95 %CI 0.0 % – 12.2 %) occurred among 23 cases. The median follow-up period was 41 months (range 10 – 84 months). Conclusions No local recurrence was detected in pT1a gastric cancers after VM1 /VMX resection by ESD. Surveillance endoscopy could be adopted for such cases without additional surgery.

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STRICTURE AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY GASTRIC CANCERS AND ADENOMAS

Digestive Endoscopy ◽

10.1111/j.1443-1661.2010.01008.x ◽

2010 ◽

Vol 22 (4) ◽

pp. 282-288 ◽

Cited By ~ 36

Author(s):

Haruhisa Iizuka ◽

Satoru Kakizaki ◽

Naondo Sohara ◽

Yasuhiro Onozato ◽

Hiroshi Ishihara ◽

...

Keyword(s):

Endoscopic Submucosal Dissection ◽

Gastric Cancers ◽

Submucosal Dissection

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Neutrophil Infiltration and the Distribution of Intestinal Metaplasia Is Associated with Metachronous Gastric Cancer following Endoscopic Submucosal Dissection

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2015/950734 ◽

2015 ◽

Vol 29 (6) ◽

pp. 321-325 ◽

Cited By ~ 9

Author(s):

Takafumi Sugimoto ◽

Yutaka Yamaji ◽

Kosuke Sakitani ◽

Yoshihiro Isomura ◽

Shuntaro Yoshida ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Endoscopic Submucosal Dissection ◽

Intestinal Metaplasia ◽

Neutrophil Infiltration ◽

Rank Test ◽

Gastric Cancers ◽

Submucosal Dissection ◽

Metachronous Gastric Cancer

BACKGROUND: Endoscopic submucosal dissection (ESD) of early gastric cancer is a minimally invasive procedure. However, the risk for metachronous cancers after successful cancer treatment remains high and the risk factors for metachronous cancers have not been elucidated.OBJECTIVE: To evaluate the risk factors for metachronous gastric cancers after ESD with a long-term follow-up.METHODS: A total of 155 consecutive patients (119 men, 36 women, mean age 68.9 years) were treated with ESD between September 2000 and September 2009. Biopsy specimens were obtained from the greater curvature of the antrum and middle corpus to evaluate gastric mucosal status, includingHelicobacter pylori, intestinal metaplasia (IM) and neutrophil infiltration (NI) before ESD. Follow-up endoscopy after ESD was scheduled at two and six months, one year and annually thereafter.H pylorieradication was recommended when possible.RESULTS: The median follow-up period was 4.2 years. Metachronous gastric cancers were found in 23 of 155 patients (3.5% per year). No local recurrences were observed. The cumulative incidence of metachronous gastric cancer was significantly high in IM and NI in the corpus (P=0.0093 and P=0.0025, respectively [log-rank test]). The ORs for IM and NI in the corpus were 2.65 and 3.06, respectively, according to the Cox proportional hazards model (P=0.024 and P=0.0091, respectively).CONCLUSIONS: The presence of IM and NI in the corpus was closely related to the development of metachronous gastric cancer after ESD.

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