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Predictive factors for local recurrence and incomplete resection of early gastric cancer treated by endoscopic resection: a Western experience
- Source :
- ResearcherID, Canadian Journal of Gastroenterology, Vol 23, Iss 5, Pp 357-363 (2009)
- Publication Year :
- 2009
-
Abstract
- BACKGROUND: Early gastric cancer (EGC) is defined as adenocarcinoma limited to the mucosa or submucosa regardless of lymph node involvement. Local EGC recurrence rates have been described in up to 6% of cases.OBJECTIVES: To evaluate predictive factors for incomplete resection and local recurrence of EGC treated by endoscopic mucosal resection (EMR) that was followed up for at least one year.METHODS: From June 1994 to December 2005, 46 patients with EGC underwent EMR. Possible predictive factors for incomplete endoscopic resection and local recurrence were identified by medical chart analysis. Demographic, endoscopic and histopathological data were retrospectively evaluated. EMR was considered complete or incomplete. Patients from the complete resection group were divided into subgroups (with and without local EGC recurrence).RESULTS: Complete resection was possible in 36 cases (76.6%). Predictive factors for incomplete resection were tumour location (P=0.035), histological type (P=0.021), lesion size (P=0.022) and number of resected fragments (P=0.013). On multivariate analysis, undifferentiated histological type (OR 0.8; 95% CI 0.036 to 0.897) and number of resected fragments (OR 7.34; 95% CI 1.266 to 42.629) were independent predictive factors for incomplete resection. In the complete resection group, a larger lesion size was associated with a higher the number of resected fragments (P=0.018). Local recurrence occurred in nine cases (25%). Use of the cap technique was the only predictive factor for local recurrence in five of seven cases (71.4%) (P=0.006).CONCLUSIONS: A larger lesion size was associated with a higher number of resected fragments. Undifferentiated adenocarcinoma and piecemeal resection were predictive factors for incomplete resection. Technique type was a predictive factor for local EGC recurrence.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Adenocarcinoma
Gastroenterology
Endoscopy, Gastrointestinal
Young Adult
Gastrectomy
Risk Factors
Stomach Neoplasms
Submucosa
Internal medicine
medicine
Gastric mucosa
Humans
lcsh:RC799-869
Lymph node
Aged
Neoplasm Staging
Retrospective Studies
Aged, 80 and over
medicine.diagnostic_test
business.industry
Incidence
digestive, oral, and skin physiology
General Medicine
Middle Aged
medicine.disease
Prognosis
digestive system diseases
Endoscopy
Early Gastric Cancer
medicine.anatomical_structure
Gastric Mucosa
lcsh:Diseases of the digestive system. Gastroenterology
Female
Original Article
Radiology
Neoplasm Recurrence, Local
business
Gastric Neoplasm
Brazil
Follow-Up Studies
Subjects
Details
- ISSN :
- 08357900
- Volume :
- 23
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Canadian journal of gastroenterology = Journal canadien de gastroenterologie
- Accession number :
- edsair.doi.dedup.....af3a7ac2d45c7fe65da8a456ed27f837