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Multicenter Study
. 2024 May 15;18(3):426-433.
doi: 10.5009/gnl230132. Epub 2023 Aug 14.

Clinical Outcome of Endoscopic Submucosal Dissection for Papillary Type Early Gastric Cancer: A Multicenter Study

Hyun-Deok Shin  1 , Ki Bae Bang  1 , Sun Hyung Kang  2 , Hee Seok Moon  2 , Jae Kyu Sung  2 , Hyun Yong Jeong  2 , Dong Kyu Lee  3 , Ki Bae Kim  4 , Sun Moon Kim  5 , Seung Woo Lee  6 , Dong Soo Lee  6 , Young Sin Cho  7 , Il-Kwun Chung  7 , Ju Seok Kim  2
Affiliations
Multicenter Study

Clinical Outcome of Endoscopic Submucosal Dissection for Papillary Type Early Gastric Cancer: A Multicenter Study

Hyun-Deok Shin et al. Gut Liver. .

Abstract

Background/aims: Papillary adenocarcinoma is classified to differentiated-type gastric cancer and is indicated for endoscopic submucosal dissection. However, due to its rare nature, there are limited studies on it. The purpose of this study was to determine the outcome of endoscopic submucosal dissection in patients with papillary-type early gastric cancer and to find the risk factors of lymph node metastasis.

Methods: Patients diagnosed with papillary-type early gastric cancer at eight medical centers, who underwent endoscopic submucosal dissection or surgical treatment, were retrospectively reviewed. The clinical results and long-term outcomes of post-endoscopic submucosal dissection were evaluated, and the risk factors of lymph node metastasis in the surgery group were analyzed.

Results: One-hundred and seventy-six patients with papillary-type early gastric cancer were enrolled: 44.9% (n=79) in the surgery group and 55.1% (n=97) in the endoscopic submucosal dissection group. As a result of endoscopic submucosal dissection, the en bloc resection and curative resection rates were 91.8% and 86.6%, respectively. The procedure-related complication rate was 4.1%, and local recurrence occurred in 3.1% of patients. Submucosal invasion (odds ratio, 3.735; 95% confidence interval, 1.026 to 12.177; p=0.047) and lymphovascular invasion (odds ratio, 7.636; 95% confidence interval, 1.730 to 22.857; p=0.004) were the risk factors of lymph node metastasis in papillary-type early gastric cancer patients.

Conclusions: The clinical results of endoscopic submucosal dissection in papillary-type early gastric cancer were relatively favorable, and endoscopic submucosal dissection is considered safe if appropriate indications are confirmed by considering the risk of lymph node metastasis.

Keywords: Endoscopic submucosal dissection; Lymph node metastasis; Papillary adenocarcinoma.

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Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Flowchart of this study. EGC, early gastric cancer; ESD, endoscopic submucosal dissection.
Fig. 2
Fig. 2
Long-term outcome of papillary type early gastric cancer patients treated with endoscopic submucosal dissection (ESD).
See this image and copyright information in PMC

Comment in

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