Effect of histologic differences between biopsy and final resection on treatment outcomes in early gastric cancer
- PDF / 1,378,901 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 58 Downloads / 204 Views
and Other Interventional Techniques
Effect of histologic differences between biopsy and final resection on treatment outcomes in early gastric cancer Yonsoo Kim1 · Hong Jin Yoon1 · Jie‑Hyun Kim1 · Jaeyoung Chun1 · Young Hoon Youn1 · Hyojin Park1 · In Gyu Kwon2 · Seung Ho Choi2 · Sung Hoon Noh2 Received: 24 June 2019 / Accepted: 28 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Background and study aims Biopsy-based histologic diagnosis is important in determining the treatment strategy for early gastric cancer (EGC). However, there are few studies on how histologic discrepancy may affect patients’ treatment outcomes. We aimed to investigate the impact of histopathologic differences between biopsy and final specimens from endoscopic resection (ER) or gastrectomy on treatment outcomes in patients with EGC. We also examined the predictive factors of histologic discrepancy. Patients and methods We analyzed the data of 1851 patients with EGC treated with ER or gastrectomy. We compared the histology between biopsies and final resected specimens from ER or gastrectomy. We also examined changes in treatment outcomes according to histologic differences. Results Histologic discrepancy was observed in 11.9% of patients in the ER group and 10.7% of those in the gastrectomy group. In patients treated with ER who showed histologic discrepancy, 80.9% showed differentiated-type EGC (D-EGC) on biopsy but undifferentiated-type-EGC (UD-EGC) after ER, of which 78.9% were non-curative resection. In patients treated with gastrectomy who showed histologic discrepancy, 39% showed UD-EGC on biopsy but showed D-EGC after gastrectomy. A total of these patients had absolute and expanded indications for ER. Moderately differentiated and poorly differentiated adenocarcinoma on biopsy were predictive factors of histologic discrepancy in UD-EGC and D-EGC on final resection, respectively. Conclusions About 10% of patients showed histologic discrepancy between biopsy and final resection with ER or gastrectomy. Histologic discrepancy can affect treatment outcomes, such as non-curative resection in ER or missing the opportunity for ER in gastrectomy. Keywords Early gastric cancer · Histology · Biopsy · Endoscopic submucosal dissection · Gastrectomy
Yonsoo Kim and Hong Jin Yoon have contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00464-019-07301-z) contains supplementary material, which is available to authorized users. * Jie‑Hyun Kim [email protected] 1
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju‑ro, Gangnam‑gu, Seoul 06273, Republic of Korea
Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju‑ro, Gangnam‑gu, Seoul 06273, Republic of Korea
2
Gastric cancer is the fifth most common cancer in the world and the third most commonly associated with cancer-related mortality [1]. Although the incide
Data Loading...
