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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.identifier.citationGASTROINTESTINAL ENDOSCOPY, v.88, n.6, p.912-918, 2018
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.relation.ispartofGastrointestinal Endoscopy
dc.titleRisk assessment of lymph node metastases in early gastric adenocarcinoma fulfilling expanded endoscopic resection criteriaeng
dc.rights.holderCopyright MOSBY-ELSEVIEReng
dc.subject.wosGastroenterology & Hepatologyeng
dc.type.categoryoriginal articleeng
hcfmusp.publisher.cityNEW YORKeng
hcfmusp.relation.referenceAbdelfatah MM, 2018, GASTROINTEST ENDOSC, V87, P338, DOI 10.1016/j.gie.2017.09.025eng
hcfmusp.relation.referenceEleftheriadis N., 2014, J TUMOR, V2, P161eng
hcfmusp.relation.referenceEtoh T, 2005, GASTROINTEST ENDOSC, V62, P868, DOI 10.1016/j.gie.2005.09.012eng
hcfmusp.relation.referenceGotoda T, 2000, GASTRIC CANCER, V3, P219, DOI 10.1007/PL00011720]eng
hcfmusp.relation.referenceGotoda T, 2007, GASTRIC CANCER, V10, P1, DOI 10.1007/s10120-006-0408-1eng
hcfmusp.relation.referenceGotoda T, 2006, J GASTROENTEROL, V41, P929, DOI 10.1007/s00535-006-1954-3eng
hcfmusp.relation.referenceHan JP, 2016, SCAND J GASTROENTERO, V51, P60, DOI 10.3109/00365521.2015.1065510eng
hcfmusp.relation.referenceHatta W, 2017, AM J GASTROENTEROL, V112, P874, DOI 10.1038/ajg.2017.95eng
hcfmusp.relation.referenceHolscher AH, 2009, ANN SURG, V250, P791, DOI 10.1097/SLA.0b013e3181bdd3e4eng
hcfmusp.relation.referenceHONDO Fabio Yuji, 2017, Arq. Gastroenterol., V54, P308, DOI [10.1590/S0004-2803.201700000-38, 10.1590/s0004-2803.201700000-38]eng
hcfmusp.relation.referenceHoriuchi Y, 2018, DIG ENDOSCeng
hcfmusp.relation.referenceJapanese Gastric Canc Assoc, 2017, GASTRIC CANCER, V20, P1, DOI 10.1007/s10120-016-0622-4eng
hcfmusp.relation.referenceJapanese Gastric Canc Assoc, 2011, GASTRIC CANCER, V14, P101, DOI 10.1007/s10120-011-0041-5eng
hcfmusp.relation.referenceJapanese Gastric Cancer Association, 1998, GASTRIC CANCER, V1, P10, DOI 10.1007/S101209800016]eng
hcfmusp.relation.referenceJin EH, 2015, WORLD J GASTROENTERO, V21, P571, DOI 10.3748/wjg.v21.i2.571eng
hcfmusp.relation.referenceKang KJ, 2011, GUT LIVER, V5, P418, DOI 10.5009/gnl.2011.5.4.418eng
hcfmusp.relation.referenceRamos MFKP, 2018, INT J SURG, V53, P366, DOI 10.1016/j.ijsu.2018.03.082eng
hcfmusp.relation.referenceLauwers G, 2010, WHO CLASSIFICATION T, P48eng
hcfmusp.relation.referenceMendonca EQ, 2017, GASTROINTEST ENDOSC, V85, pAB455, DOI 10.1016/j.gie.2017.03.1058eng
hcfmusp.relation.referenceOh SY, 2017, ANN SURG, V265, P137, DOI 10.1097/SLA.0000000000001649eng
hcfmusp.relation.referencePereira MA, 2018, J SURG ONCOL, V117, P829, DOI 10.1002/jso.25022eng
hcfmusp.relation.referencePereira MA, 2018, J GASTROINTEST SURG, V22, P23, DOI 10.1007/s11605-017-3517-8eng
hcfmusp.relation.referenceProbst A, 2017, ENDOSCOPY, V49, P222, DOI 10.1055/s-0042-118449eng
hcfmusp.relation.referenceTang LH, 2013, CAP STOMACH PROTOCOLeng
hcfmusp.relation.referenceWashington K, 2010, ANN SURG ONCOL, V17, P3077, DOI 10.1245/s10434-010-1362-zeng
hcfmusp.relation.referenceYamamoto H, 2005, BEST PRACT RES CL GA, V19, P909, DOI 10.1016/j.bpg.2005.03.004eng
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Artigos e Materiais de Revistas Científicas - FM/MGT
Departamento de Gastroenterologia - FM/MGT

Artigos e Materiais de Revistas Científicas - FM/MPT
Departamento de Patologia - FM/MPT

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HU
Hospital Universitário - HU

Artigos e Materiais de Revistas Científicas - LIM/14
LIM/14 - Laboratório de Investigação em Patologia Hepática

Artigos e Materiais de Revistas Científicas - LIM/37
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado

Artigos e Materiais de Revistas Científicas - LIM/38
LIM/38 - Laboratório de Epidemiologia e Imunobiologia

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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