FERNANDA CRISTINA SIMOES PESSORRUSSO

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Autor e Coautores FMUSP-HC Normalizados: EVANDRO SOBROZA DE MELLO × Autor e Coautores FMUSP-HC Normalizados: FERNANDA CRISTINA SIMOES PESSORRUSSO ×

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  • conferenceObject
    VALIDATION OF EXPANDED ENDOSCOPIC SUBMUCOSAL DISSECTION CRITERIA FOR TREATMENT OF EARLY GASTRIC ADENOCARCINOMA IN A WESTERN CENTER
    (2018) PESSORRUSSO, Fernanda C.; FELIPE-SILVA, Aloisio; JACOB, Carlos E.; RAMOS, Marcus F.; ZILBERSTEIN, Bruno; ALVES, Venancio A.; MELLO, Evandro S.; PEREIRA, Marina; CECCONELLO, Ivan; RIBEIRO, Ulysses; MALUF-FILHO, Fauze
  • article 13 Citação(ões) na Scopus
    Risk assessment of lymph node metastases in early gastric adenocarcinoma fulfilling expanded endoscopic resection criteria
    (2018) PESSORRUSSO, Fernanda Cristina Simoes; FELIPE-SILVA, Aloisio; JACOB, Carlos Eduardo; RAMOS, Marcus Fernando Kodama Pertille; FERREIRA, Venancio Avancini Alves; MELLO, Evandro Sobroza de; ZILBERSTEIN, Bruno; RIBEIRO JR., Ulysses; MALUF-FILHO, Fauze
    Background 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.