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Clinical Outcomes of Early Gastric Cancer Treated by Additional Gastrectomy after Non-curative Endoscopic Submucosal Dissection Takuo Takehana 1 , Tsuneo Oyama 2 , Kazuhiro Yamamoto 1 , Shunsuke Kawai 1 , Rui Marukuchi 1 , Takeshi Hasegawa 1 , Akiko Takahashi 2 , Nobukazu Yorimitsu 2 , Ryutaro Furukawa 2 , Jiro Nakamura 3 1Department of Surgery, Saku Central Hospital Advanced Care Center, Saku, Japan 2Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan 3Department of Surgery, Karuizawa Hospital, Karuizawa, Japan Keyword: 胃癌ESD , ESD適応外 , 追加手術 , 長期予後 pp.1592-1600
Published Date 2014/10/25
DOI https://doi.org/10.11477/mf.1403200029
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 A total of 2,295 patients with early gastric cancer were treated by ESD(endoscopic submucosal dissection)at our hospital from January 2000 to December 2013. Non-curative resection was observed in 271 patients ; all of them were recommended to be treated by additional gastrectomy, but only 97 patients underwent additional gastrectomy. Pathological analysis revealed lymph node metastases in 8 patients. Non-depressed type(elevated or flat type), in macroscopic type classification, and venous invasion were the risk factors for lymph node metastasis.

 Metachronous distant metastases were detected in 3 patients, and among them, para-abdominal aortic lymph node metastasis was detected in one. All the 3 patients with recurrence died of gastric cancer. Seventy-six of 79(96%)patients with T1b undergoing additional gastrectomy survived without recurrence. Therefore, additional gastrectomy following non-curative ESD was a useful strategy for early T1b gastric cancer and surgical gastrectomy.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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