Treatment for Intramucosal Gastric Cancer with Mixed Type Histology(Differentiated and Undifferentiated) Kohei Takizawa 1 , Noboru Kawata 1 , Masaki Tanaka 1 , Naomi Kakushima 1 , Kenichiro Imai 1 , Hiroyuki Matsubayashi 1 , Kinichi Hotta 1 , Etsuro Bando 2 , Masanori Terashima 2 , Takashi Sugino 3 , Hiroyuki Ono 1 1Endoscopy Division, Shizuoka Cancer Center, Shizuoka, Japan 2Gastric Surgery Division, Shizuoka Cancer Center, Shizuoka, Japan 3Pathology Division, Shizuoka Cancer Center, Shizuoka, Japan Keyword: 早期胃癌 , 未分化型腺癌 , 組織混在 , ESD , 適応拡大 pp.1567-1579
Published Date 2013/10/25
DOI https://doi.org/10.11477/mf.1403113965
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 Clinicopathological data were reviewed from 604 patients who underwent surgical resection for intramucosal EGC(early gastric cancer). Lesions were classified into four types according to the proportion of differentiated and undifferentiated components in histopathology : PD(pure differentiated)type, MD(mixed predominantly differentiated)type, MU(mixed predominantly undifferentiated)type, and PU(pure undifferentiated)type. LN metastasis was more common in MD than in PD, and in MU than in PU.

 According to the multicenter retrospective analysis, intramucosal lesions less than 30mm with ulceration without lymphovascular invasion, the rate of LN metastasis was 0% for MD(0/370). Further investigation is required to determine whether mixed type intramucosal gastric cancer with predominantly differentiated component, less than 30mm, with ulceration, and without lymphovascular invasion could be managed as curative resection after ESD.

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