Clinical outcomes of no residual disease in the specimen after endoscopic resection for gastric neoplasms.

Choi, Ji; Kim, Sang; Yang, Hyo-Joon; Lim, Joo; Choi, Jeongmin; Im, Jong; Kim, Joo; Kim, Woo; Jung, Hyun; Choi, Ji Min; Kim, Sang Gyun; Lim, Joo Hyun; Im, Jong Pil; Kim, Joo Sung; Kim, Woo Ho; Jung, Hyun Chae

<bold>Background: </bold>No residual disease (NRD) can be found in the specimen after endoscopic resection (ER) of biopsy-proven gastric neoplasm. This study aimed to evaluate the endoscopic and pathologic characteristics of patients with NRD and identify the cause and long-term prognosis.<bold>Methods: </bold>Medical records of patients who underwent ER for biopsy-proven gastric neoplasms at a single tertiary hospital between January 2005 and November 2014 were retrospectively reviewed. Patients whose post-ER histology was revealed as NRD were included. Overall incidence, clinicopathologic characteristics, cause, and long-term prognosis were analyzed.<bold>Results: </bold>NRD was detected in 143 (3.2%) of 4401 cases of gastric neoplasms treated with ER. Mean endoscopic size of the initial lesion was 8.15 ± 6.64 mm; in 93 cases (65.0%), the lesion was located in the lower third of the stomach. Initial pathologic diagnosis was as follows: adenoma (n = 110), carcinoma (n = 29), and atypical gland (n = 4). The causes of NRD were minute lesions removed by biopsy in 140 patients, pathologic misdiagnoses in two, and localization error in one. Local recurrence was detected in five patients (3.6%) with minute lesions during follow-up and treated with argon plasma coagulation (n = 4) or re-ER (n = 1). Synchronous (n = 5, 3.6%) and metachronous gastric lesions (n = 6, 4.3%) were also detected during follow-up.<bold>Conclusions: </bold>The main cause of NRD was minute lesions which might be completely removed by initial diagnostic biopsy. These cases showed a minimal rate of local recurrence and synchronous or metachronous gastric neoplasms. Careful follow-up is also mandatory for detection of residual disease.

STOMACH surgery; STOMACH cancer; SURGICAL excision; ENDOSCOPIC surgery; LAPAROSCOPIC surgery; ONCOLOGIC surgery; CARCINOGENESIS; ELECTROCOAGULATION (Medicine); ADENOMA; BIOPSY; CANCER; CANCER relapse; GASTROSCOPY; MULTIPLE tumors; PROGNOSIS; STOMACH tumors; DISEASE incidence; RETROSPECTIVE studies

Surgical Endoscopy & Other Interventional Techniques, 2016, Vol 30, Issue 2, p610

1866-6817

Academic Journal

10.1007/s00464-015-4248-0