Risk assessment of lymph node metastases in early gastric adenocarcinoma fulfilling expanded endoscopic resection criteria

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorPESSORRUSSO, Fernanda Cristina Simoes
dc.contributor.authorFELIPE-SILVA, Aloisio
dc.contributor.authorJACOB, Carlos Eduardo
dc.contributor.authorRAMOS, Marcus Fernando Kodama Pertille
dc.contributor.authorFERREIRA, Venancio Avancini Alves
dc.contributor.authorMELLO, Evandro Sobroza de
dc.contributor.authorZILBERSTEIN, Bruno
dc.contributor.authorRIBEIRO JR., Ulysses
dc.contributor.authorMALUF-FILHO, Fauze
dc.date.accessioned2019-01-17T13:36:44Z
dc.date.available2019-01-17T13:36:44Z
dc.date.issued2018
dc.description.abstractBackground and Aims: Early gastric cancer (EGC) is known to present a low rate of lymph node metastases (LNMs). Gastrectomy with D2 lymphadenectomy is usually curative for EGC. Endoscopic submucosal dissection (ESD) is a well-accepted treatment modality for lesions that meet the classic criteria: those mucosal differentiated adenocarcinoma measuring 20 mm or less, without ulceration. Expanded criteria for ESD have been proposed based on a null LNM rate from large gastrectomy series from Japan. Patients with LNM have been reported in Western centers, heightening the need for validation of expanded criteria. Our aim was to assess the risk of LNM in gastrectomy specimens of patients with EGC who met the expanded criteria for ESD. Methods: We conducted an evaluation of gastrectomy specimens including LNM staging of patients submitted to gastrectomy for EGC in a 39-year retrospective cohort. Results: A total of 389 surgical specimens were included. From them, 135 fulfilled criteria for endoscopic resection. None of the 31 patients with classic criteria had LNM. From the 104 patients with expanded criteria, 3 had LNM (n = 104 [2.9%], 95% confidence interval,.7%-8.6%), all of them with undifferentiated tumors without ulceration, measuring less than 20 mm. Conclusions: There is a small risk of LNM in EGC when expanded criteria for ESD are met. Refinement of the expanded criteria for the risk of LNM may be desirable in a Brazilian cohort. Meanwhile, the decision to complement the endoscopic treatment with gastrectomy will have to take into consideration the individual risk of perioperative morbidity and mortality.eng
dc.description.indexMEDLINEeng
dc.identifier.citationGASTROINTESTINAL ENDOSCOPY, v.88, n.6, p.912-918, 2018
dc.identifier.doi10.1016/j.gie.2018.07.023
dc.identifier.eissn1097-6779
dc.identifier.issn0016-5107
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/30066
dc.language.isoeng
dc.publisherMOSBY-ELSEVIEReng
dc.relation.ispartofGastrointestinal Endoscopy
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright MOSBY-ELSEVIEReng
dc.subject.othersubmucosal-dissectioneng
dc.subject.othercancereng
dc.subject.otherexperienceeng
dc.subject.othermarkerseng
dc.subject.wosGastroenterology & Hepatologyeng
dc.titleRisk assessment of lymph node metastases in early gastric adenocarcinoma fulfilling expanded endoscopic resection criteriaeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus13
hcfmusp.contributor.author-fmusphcFERNANDA CRISTINA SIMOES PESSORRUSSO
hcfmusp.contributor.author-fmusphcALOISIO SOUZA FELIPE DA SILVA
hcfmusp.contributor.author-fmusphcCARLOS EDUARDO JACOB
hcfmusp.contributor.author-fmusphcMARCUS FERNANDO KODAMA PERTILLE RAMOS
hcfmusp.contributor.author-fmusphcVENANCIO AVANCINI FERREIRA ALVES
hcfmusp.contributor.author-fmusphcEVANDRO SOBROZA DE MELLO
hcfmusp.contributor.author-fmusphcBRUNO ZILBERSTEIN
hcfmusp.contributor.author-fmusphcULYSSES RIBEIRO JUNIOR
hcfmusp.contributor.author-fmusphcFAUZE MALUF FILHO
hcfmusp.description.beginpage912
hcfmusp.description.endpage918
hcfmusp.description.issue6
hcfmusp.description.volume88
hcfmusp.origemWOS
hcfmusp.origem.pubmed30053392
hcfmusp.origem.scopus2-s2.0-85052955299
hcfmusp.origem.wosWOS:000450323100004
hcfmusp.publisher.cityNEW YORKeng
hcfmusp.publisher.countryUSAeng
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hcfmusp.scopus.lastupdate2024-05-10
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