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Follow-up outcomes of endoscopic resection for early gastric cancer with undifferentiated histology

机译：内镜切除术对未分化的早期胃癌的随访结果

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Background: The application of endoscopic resection (ER) for undifferentiated-type early gastric cancer (UD-EGC) remains controversial. The aim was to examine long-term outcomes of ER for UD-EGC. Furthermore, we investigated whether long-term outcomes of ER differed between poorly differentiated adenocarcinoma (PD) and signet ring cell carcinoma (SRC). Methods: From 2001 to 2011, 209 lesions in 209 patients with UD-EGC (82 PD; 127 SRC) were treated by ER. We retrospectively assessed the clinical outcomes of ER in 209 patients. The survival rate and disease-free survival rates after ER were evaluated as long-term outcomes. Results: The en bloc resection and curative resection (CR) rates were 91.4 and 55.0 %, respectively. The en bloc and CR rates in PD were 90.2 and 45.1 %, whereas those in SRC were 92.1 and 61.4 %. For patients with PD who underwent non-curative resections, 51.1 % were vertical-cut end-positive and for those with SRC, 63.3 % were lateral-cut end-positive, a statistically significant difference. In those patients where CR was achieved, no case of local recurrence or distant metastasis was observed during the follow-up period (32.7 ± 22.2 months). The 3- and 5-year survival rates were 99.0 and 98.6 %, with no significant difference between CR patients with SRC and PD. Conclusions: ER may yield good long-term outcomes for UD-EGC if CR is achieved, with no difference between PD and SRC. However, to increase the current CR rate of ER, stricter criteria for performing ER in UD-EGC may be required.
机译：背景：内镜切除术（ER）在未分化型早期胃癌（UD-EGC）中的应用仍存在争议。目的是检查UD-EGC的ER的长期结果。此外，我们调查了低分化腺癌（PD）和印戒细胞癌（SRC）之间ER的长期结局是否存在差异。方法：从2001年至2011年，对209例UD-EGC（82 PD; 127 SRC）患者的209个病变进行了ER治疗。我们回顾性评估了209例ER的临床结局。 ER后的生存率和无病生存率被评估为长期结果。结果：整体切除和根治性切除（CR）率分别为91.4％和55.0％。 PD的整体和CR率分别为90.2和45.1％，而SRC的整体和CR率分别为92.1和61.4％。对于进行非根治性切除的PD患者，垂直切开端阳性率为51.1％，而对于SRC的患者，侧面切开端阳性率为63.3％，具有统计学意义。在随访期间（32.7±22.2个月），未见CR的患者出现局部复发或远处转移。 CR和SRC患者的3年和5年生存率分别为99.0％和98.6％。结论：如果达到CR，ER可能对UD-EGC产生良好的长期预后，PD和SRC之间没有差异。但是，为了提高当前ER的CR率，可能需要更严格的标准以在UD-EGC中执行ER。

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