Abstract
BackgroundRecent studies have shown that mixed predominantly differentiated-type (MD) early gastric cancer (EGC) might have more malignant potential than pure differentiated-type (PD) EGC. However, no study has analyzed all differentiated-type EGC cases treated endoscopically and surgically. This study aimed to compare the differences in clinicopathological features and long-term prognosis between MD- and PD-EGC.MethodsWe evaluated all patients with differentiated-type EGCs who were treated endoscopically and surgically in our hospital between January 2010 and October 2014. The clinicopathological features and long-term prognosis of MD-EGC were compared with those of PD-EGC.ResultsA total of 459 patients with 459 lesions were evaluated in this study; of them, 409 (89.1%) and 50 (10.9%) were classified into the PD and MD groups, respectively. Submucosal invasion was found in 96 (23.5%) patients of the PD group and in 33 (66.0%) patients of the MD group (p < 0.01). The rates of positive lymphatic and vascular invasion and ulceration were significantly higher in the MD group than in the PD group (p < 0.01). The proportion of patients with lymph node metastasis was also significantly higher in the MD group than in the PD group (5 (10%) vs 6 (1.5%), p < 0.01). The 5-year overall and EGC-specific survival rates in the PD group were 88.3 and 99.5%, respectively, while they were 94.0 and 98.0% in the MD group, respectively.ConclusionsMD-EGC has more malignant potential than PD-EGC. However, the long-term prognosis of MD-EGC is good and is not significantly different from that of PD-EGC when treated appropriately.
Highlights
Recent studies have shown that mixed predominantly differentiated-type (MD) early gastric cancer (EGC) might have more malignant potential than pure differentiated-type (PD) EGC
Previous reports showed that compared with the pure differentiatedtype EGC, predominantly differentiated-type EGC including undifferentiated-type components treated with endoscopic submucosal dissection (ESD) resulted in higher non-curative resection rates [14,15,16]
This study aimed to compare the differences in clinicopathologic features and long-term prognosis between mixed predominantly differentiated-type (MD)-EGC and pure differentiated-type (PD)-EGC treated with ESD or gastrectomy and to identify whether MD-EGC can be an appropriate indication of ESD and followed-up without additional treatment after ESD if the criteria of curative endoscopic resection were met
Summary
Recent studies have shown that mixed predominantly differentiated-type (MD) early gastric cancer (EGC) might have more malignant potential than pure differentiated-type (PD) EGC. No study has analyzed all differentiated-type EGC cases treated endoscopically and surgically. Previous reports showed that compared with the pure differentiatedtype EGC, predominantly differentiated-type EGC including undifferentiated-type components treated with ESD resulted in higher non-curative resection rates [14,15,16]. Mixed histological type EGC may have more malignant potential; these previous reports have analyzed ESD cases only or gastrectomy cases only, resulting in selection bias. This study aimed to compare the differences in clinicopathologic features and long-term prognosis between mixed predominantly differentiated-type (MD)-EGC and pure differentiated-type (PD)-EGC treated with ESD or gastrectomy and to identify whether MD-EGC can be an appropriate indication of ESD and followed-up without additional treatment after ESD if the criteria of curative endoscopic resection were met
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