Lymph Node Metastasis in Mucosal Gastric Cancer: Reappraisal of Expanded Indication of Endoscopic Submucosal Dissection

Oh, Seung-Young MD, MS; Lee, Kyung-Goo MD, MS; Suh, Yun-Suhk MD, MS; Kim, Min A. MD, PhD; Kong, Seong-Ho MD, PhD; Lee, Hyuk-Joon MD, PhD; Kim, Woo Ho MD, PhD; Yang, Han-Kwang MD, PhD

Annals of Surgery: January 2017 - Volume 265 - Issue 1 - p 137–142

doi: 10.1097/SLA.0000000000001649

Original Articles

Objective: To evaluate risk factors for lymph node (LN) metastasis in mucosal gastric cancer, particularly the effect of cellular differentiation, and implications for the indication of endoscopic submucosal dissection (ESD).

Summary Background Data: The indication of ESD has been expanded to undifferentiated-type (UD-type) gastric cancer despite risk of LN metastasis.

Conclusions: Because UD-type cancer is a risk factor for LN metastasis in mucosal gastric cancer, ESD cannot be concluded to be a better option than surgery in all UD-type cancer patients. Redefinition of the expanded indication of ESD is required.

http://journals.lww.com/annalsofsurgery/Abstract/2017/01000/Lymph_Node_Metastasis_in_Mucosal_Gastric_Cancer_.23.aspx