P-069 - Risk Factors of Submucosal or Lymphovascular Metastasis during resection of the Early Gastric Cancer by Endoscopic Submucosal Dissection

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Gastric Cancer
Surgery and/or Radiotherapy of Cancer
Presenter J.G. Shin
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors J.G. Shin, D.H. Kang, H.W. Kim, C.W. Choi, S.B. Park, S.J. Kim, J.H. Jeon, W.C. Kim, H.S. Nam
  • Pusan National University Yangsan Hospital, Yangsan/KR

Abstract

Introduction

In determining the suitability of the endoscopic submucosal dissection (ESD), the possibility of lymph node metastasis is important consideration. The possibility of lymph node metastasis is important to the assessment of the indication for endoscopic submucosal dissection (ESD). Submucosal and lymphovascular invasion are estimate to be significant independent risk factor of lymph node metastasis in early gastric cancer resected by ESD. Nevertheless, the exact depth of invasion prior to ESD remains a challenge and can only be confirmed by final pathologic report following ESD. The purpose of the study is to inspect the risk factors for SM/LV invasion in EGC.

Methods

We retrospectively reviewed clinicopathological data of patients underwent ESD from July 2008 to June 2013 and presenting EGC of 2.0 cm or smaller in size, a differentiated-type adenocarcinoma, and without ulceration.

Results

Among 515 lesions consecutively resected by ESD, 410 lesions in 396 patients were included in this study. Submucosal and lymphovascular invasions were detected in 56 lesions. Multivariate analysis revealed two independent risk factors for SM/LV invasions: Histology of moderate-differentiated (odds ratio (OR) 4.081; 95% CI 1.931-8.759; P = 0.001), location of upper and middle third (U/M) of stomach (OR 2.931, 95% CI 1.323-6.132; P = 0.009).

Conclusion

Histology of moderate-differentiated adenocarcinoma, and location of U/M were recognized as independent risk factors of SM/LV invasion in EGC, as entirely criteria for ESD.

Table 1. Characteristics of EGC lesions resected by ESD which were >2 cm in tumor size and a histologically differentiated type of adenocarcinoma without ulceration

Table: P-069. Characteristics of ECG lesions resected by ESD which were ≤2 cm in tumor size and a histologically differentiated type of adenocarcinoma without ulceration