Endoscopists' view on superficial spreading type of early gastric cancer – endoscopic resection or surgery?

Abstract

Objective. The superficial spreading type of early gastric cancer (EGC) possesses unique features different from other types of EGC. We aimed to elucidate the clinicopathological features of superficial spreading type of EGC. Material and methods. We analyzed 1455 EGC lesions from 1398 patients who had undergone surgical treatment at Samsung Medical Center from 2000 to 2002. Then the clinicopathological features of 224 superficial-spreading EGC lesions (15.4%) was compared to that of 1231 lesions of a common type of EGC. Results. In the superficial spreading type of EGC, the incidence of undifferentiated type and submucosal invasion were higher than those of common type of EGC (55.4 vs 38.0%, p < .01 and 58.5 vs 37.8%, p < .01, respectively). Lymph node metastasis and lymphovascular invasion were more frequent in superficial spreading type than in common type of EGC (19.2 vs 7.6%, p < .01 and 15.2 vs 7.4%, p < .01, respectively). There was no difference in recurrence rate or 5-year survival rate between the two groups. Conclusion. Considering higher risk of submucosal invasion and lymph node metastasis in superficial spreading type, a careful consideration should be done before the application of endoscopic resection to the superficial spreading type of EGC.

Key Words::

• Early gastric cancer
• superficial spreading type

Acknowledgements

Beom Jin Kim: conception, design, analysis, and interpretation of the data, and drafting of the manuscript. Jun Haeng Lee: conception, design, analysis, and interpretation of the data, and drafting of the manuscript. Sang Soo Bae: conception, design, and analysis and interpretation of the data. Sang-Jung Kim: conception, design, and analysis of the data. Hee Jung Son: critical revision of the manuscript for intellectual content. Poong-Lyul Rhee: critical revision of the manuscript for intellectual content. Jae J. Kim: critical revision of the manuscript for intellectual content. Jong Chul Rhee: critical revision of the manuscript for intellectual content. Tae Sung Son: acquisition and interpretation of the data. Jae Hyung Noh: acquisition and interpretation of the data. Sung Kim: acquisition and analysis of the data. Kyung Mee Kim: acquisition and interpretation of the data. Chul Keun Park: acquisition and interpretation of the data.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.