Korean J Helicobacter  Up Gastrointest Res Search


The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2007;7(1):13-19.
Published online June 1, 2007.
Clinical Characteristics and Lymph Node Status in the Patients with Gastrectomy after Endoscopic Mucosal Resection for Early Gastric Cancer
조기위암의 내시경 점막절제술 후 추가적인 위절제술을 시행받은 환자들의 임상 양상 및 림프절 전이 상태
송지현·김재준·이준행·민병훈·양 선·박신실·김영호·장동경·손희정·이풍렬·이종철
성균관대학교 의과대학 삼성서울병원 내과학교실
Background/Aims: This study was conducted to evaluate the predictive factors of residual cancer or lymph node metastasis in patients with early gastric cancer (EGC) treated by endoscopic mucosal resection (EMR). Methods: We retrospectively analyzed 34 patients with EGC who underwent gastrectomy as a result of incomplete resection by EMR at Samsung medical center from January 2000 to December 2004. Results: The positive residual cancer rate was 45.5% (5/11) in positive lateral margin, 19.0% (4/21) in submucosal invasion, and 20.0% (1/5) in undifferentiated subtype. Tumor size in the group of positive residual cancer in remnant stomach was 4.0 cm, which was significantly larger than that of negative residual cancer (1.8 cm). There was no significant difference between these groups with respect to location, endoscopic finding, differentiation, or invasion depth. The factors of positive lateral margin and size larger than 3 cm were associated with higher risk of residual cancer, but multivariate analysis showed no statistical significance. There were 2 cases of lymph node metastasis and all showed submucosal invasion. Conclusions: The risk of residual cancer was higher in the case with positive lateral margin and size larger than 3 cm. Surgery is recommended when there is submucosal invasion. (The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2007;7:13-19)
Key Words: Early gastric cancer, Endoscopic mucosal resection, Gastrectomy, Lymph node metastasis

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