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Characteristics of proximal early gastric cancer differentiating distal early gastric cancer


Autoři: Jin Sung Koh aff001;  Moon Kyung Joo aff001;  Jong-Jae Park aff001;  Beom Jae Lee aff001;  Hoon Jai Chun aff002;  Sang Woo Lee aff003;  You-Jin Jang aff004;  Young-Jae Mok aff004
Působiště autorů: Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-ro, Guro-gu, Seoul, Republic of Korea aff001;  Division of Gastroenterology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, Republic of Korea aff002;  Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, Republic of Korea aff003;  Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Gurodong-ro, Guro-gu, Seoul, Republic of Korea aff004
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223284

Souhrn

Previous studies reported substantial differences between proximal and distal gastric cancer, however, most of the cases included in these studies were advanced gastric cancers (AGCs). The aim of this study was to investigate the unique characteristics of proximal early gastric cancer (EGC) by comparing with distal EGC. From March 2007 to March 2016, proximal and distal EGC patients who underwent endoscopic or surgical resection at our institution were matched 1:3 according to age and sex. We retrospectively analyzed the clinical and histopathological information. A total of 368 patients were enrolled including 92 (25%) in the proximal and 276 (75%) in the distal group. The proportion of patients who underwent surgery (56.5 vs. 20.3%, p<0.001), undifferentiated type (38.0 vs. 19.6%, p<0.001), tumor size (29.5 ±19.4 vs. 20.3 ±16.8 mm, p<0.001) and submucosal (SM) invasion (60.9 vs. 25.7%, p<0.001) were significantly higher in the proximal group than in the distal group. In multivariate analysis, the proximal location of EGC was a significant risk factor for SM invasion in the total population (odds ratio [OR], 3.541; 95% confidence interval [CI], 2.053–6.110; p<0.001), and in subgroup with EGC < 30mm (n = 279) (OR, 5.940; 95% CI, 2.974–11.862; p<0.001). In conclusion, careful therapeutic decision of proximal EGC is essential due to the different histopathological characteristics such as large tumor size and higher potential for SM invasion.

Klíčová slova:

Endoscopy – Gastric cancer – Stomach – Surgical and invasive medical procedures – Surgical resection – Differentiated tumors – Cancer risk factors – Endoscopic surgery


Zdroje

1. Herrero R, Park JY, Forman D. The fight against gastric cancer—the IARC Working Group report. Best practice & research Clinical gastroenterology. 2014;28(6):1107–14. doi: 10.1016/j.bpg.2014.10.003 25439075.

2. Fujitani K, Yang HK, Mizusawa J, Kim YW, Terashima M, Han SU, et al. Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA): a phase 3, randomised controlled trial. The Lancet Oncology. 2016;17(3):309–18. doi: 10.1016/S1470-2045(15)00553-7 26822397.

3. Ahn JY, Jung HY. Long-term outcome of extended endoscopic submucosal dissection for early gastric cancer with differentiated histology. Clin Endosc. 2013;46(5):463–6. doi: 10.5946/ce.2013.46.5.463 24143303; PubMed Central PMCID: PMC3797926.

4. Gotoda T. Endoscopic resection of early gastric cancer. Gastric Cancer. 2007;10(1):1–11. doi: 10.1007/s10120-006-0408-1 17334711.

5. Bang CS, Park JM, Baik GH, Park JJ, Joo MK, Jang JY, et al. Therapeutic Outcomes of Endoscopic Resection of Early Gastric Cancer with Undifferentiated-Type Histology: A Korean ESD Registry Database Analysis. Clin Endosc. 2017;50(6):569–77. doi: 10.5946/ce.2017.017 28743132; PubMed Central PMCID: PMC5719916.

6. Kim JS, Kang SH, Moon HS, Lee ES, Kim SH, Sung JK, et al. Clinical outcome after endoscopic submucosal dissection for early gastric cancer of absolute and expanded indication. Medicine (Baltimore). 2017;96(17):e6710. doi: 10.1097/MD.0000000000006710 28445280; PubMed Central PMCID: PMC5413245.

7. Holscher AH, Drebber U, Monig SP, Schulte C, Vallbohmer D, Bollschweiler E. Early gastric cancer: lymph node metastasis starts with deep mucosal infiltration. Ann Surg. 2009;250(5):791–7. doi: 10.1097/SLA.0b013e3181bdd3e4 19809298.

8. Tsujii Y, Kato M, Inoue T, Yoshii S, Nagai K, Fujinaga T, et al. Integrated diagnostic strategy for the invasion depth of early gastric cancer by conventional endoscopy and EUS. Gastrointest Endosc. 2015;82(3):452–9. doi: 10.1016/j.gie.2015.01.022 25841580.

9. Choi J, Kim SG, Im JP, Kim JS, Jung HC, Song IS. Endoscopic prediction of tumor invasion depth in early gastric cancer. Gastrointest Endosc. 2011;73(5):917–27. doi: 10.1016/j.gie.2010.11.053 21316050.

10. Choi J, Kim SG, Im JP, Kim JS, Jung HC, Song IS. Comparison of endoscopic ultrasonography and conventional endoscopy for prediction of depth of tumor invasion in early gastric cancer. Endoscopy. 2010;42(9):705–13. doi: 10.1055/s-0030-1255617 20652857.

11. Choi J, Kim SG, Im JP, Kim JS, Jung HC, Song IS. Is endoscopic ultrasonography indispensable in patients with early gastric cancer prior to endoscopic resection? Surg Endosc. 2010;24(12):3177–85. doi: 10.1007/s00464-010-1112-0 20490559.

12. Huang Q, Sun Q, Fan XS, Zhou D, Zou XP. Recent advances in proximal gastric carcinoma. J Dig Dis. 2016;17(7):421–32. doi: 10.1111/1751-2980.12355 27129018.

13. Japanese Gastric Cancer A. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14(2):101–12. doi: 10.1007/s10120-011-0041-5 21573743.

14. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003;58(6 Suppl):S3–43. doi: 10.1016/s0016-5107(03)02159-x 14652541.

15. Gotoda T, Yanagisawa A, Sasako M, Ono H, Nakanishi Y, Shimoda T, et al. Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer. 2000;3(4):219–25. 11984739.

16. Japanese Gastric Cancer A. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20(1):1–19. doi: 10.1007/s10120-016-0622-4 27342689; PubMed Central PMCID: PMC5215069 Phamaceutical, Sanofi, Merck Serono, Yakult Honsha, Daiichi Sankyo, Otsuka Pharmaceutical Factory, Takeda Pharmaceutical, Johnson & Johnson, Asahi Kasei Pharma, Eli Lilly Japan, Pfizer Japan, AJINOMOTO Pharmaceuticals, ONO Pharmaceutical and Kaken Pharmaceutical and grants from Covidien Japan, Shionogi, Bristol Myers Squib, Japan Blood Products Organization, Torii Pharmaceutical, Mitsubishi Tanabe Pharma, bbVie GK, Otsuka Pharmaceutical, Yoshindo, Eizai, Abbott Japan, CSL Behring, Teijin Pharma, Tsumura, Nippon Kayaku, Miyarisan Pharmaceutical, Novartis Pharmaceuticals Japan, KCI, Toyama Chemical, Maruho, Hogy Medical and MSD, outside the submitted work. Dr. Sano reports personal fees from Chugai Phamaceutical, Covidien Japan, Eli Lilly Japan, Johnson & Johnson, Olympus, Otsuka Pharmaceutical Factory, Taiho Pharmaceutical and Yakult Honsha.

17. Biondi A, Persiani R, Cananzi F, Zoccali M, Vigorita V, Tufo A, et al. R0 resection in the treatment of gastric cancer: room for improvement. World J Gastroenterol. 2010;16(27):3358–70. doi: 10.3748/wjg.v16.i27.3358 20632437; PubMed Central PMCID: PMC2904881.

18. Saito H, Fukumoto Y, Osaki T, Fukuda K, Tatebe S, Tsujitani S, et al. Distinct recurrence pattern and outcome of adenocarcinoma of the gastric cardia in comparison with carcinoma of other regions of the stomach. World J Surg. 2006;30(10):1864–9. doi: 10.1007/s00268-005-0582-z 16983479.

19. Tajima Y, Yamazaki K, Makino R, Nishino N, Masuda Y, Aoki S, et al. Differences in the histological findings, phenotypic marker expressions and genetic alterations between adenocarcinoma of the gastric cardia and distal stomach. Br J Cancer. 2007;96(4):631–8. doi: 10.1038/sj.bjc.6603583 17262083; PubMed Central PMCID: PMC2360051.

20. An JY, Baik YH, Choi MG, Noh JH, Sohn TS, Bae JM, et al. The prognosis of gastric cardia cancer after R0 resection. Am J Surg. 2010;199(6):725–9. doi: 10.1016/j.amjsurg.2009.04.012 19837398.

21. Huang Q, Fang C, Shi J, Sun Q, Wu H, Gold JS, et al. Differences in Clinicopathology of Early Gastric Carcinoma between Proximal and Distal Location in 438 Chinese Patients. Sci Rep. 2015;5:13439. doi: 10.1038/srep13439 26310451; PubMed Central PMCID: PMC4550893.

22. Ichikawa D, Komatsu S, Kosuga T, Konishi H, Okamoto K, Shiozaki A, et al. Clinicopathological characteristics of clinical early gastric cancer in the upper-third stomach. World J Gastroenterol. 2015;21(45):12851–6. doi: 10.3748/wjg.v21.i45.12851 26668509; PubMed Central PMCID: PMC4671040.

23. Coupland VH, Lagergren J, Konfortion J, Allum W, Mendall MA, Hardwick RH, et al. Ethnicity in relation to incidence of oesophageal and gastric cancer in England. Br J Cancer. 2012;107(11):1908–14. doi: 10.1038/bjc.2012.465 23059745; PubMed Central PMCID: PMC3504951.

24. Park JC, Lee YC, Kim JH, Kim YJ, Lee SK, Shin SK, et al. Clinicopathological features and prognostic factors of proximal gastric carcinoma in a population with high Helicobacter pylori prevalence: a single-center, large-volume study in Korea. Annals of surgical oncology. 2010;17(3):829–37. doi: 10.1245/s10434-009-0785-x 19882188.

25. Liu Y, Kaneko S, Sobue T. Trends in reported incidences of gastric cancer by tumour location, from 1975 to 1989 in Japan. International journal of epidemiology. 2004;33(4):808–15. doi: 10.1093/ije/dyh053 15020567.

26. El-Serag HB, Mason AC, Petersen N, Key CR. Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA. Gut. 2002;50(3):368–72. doi: 10.1136/gut.50.3.368 11839716; PubMed Central PMCID: PMC1773122.

27. Maeda H, Okabayashi T, Nishimori I, Sugimoto T, Namikawa T, Dabanaka K, et al. Clinicopathologic features of adenocarcinoma at the gastric cardia: is it different from distal cancer of the stomach? Journal of the American College of Surgeons. 2008;206(2):306–10. doi: 10.1016/j.jamcollsurg.2007.06.306 18222384.

28. Okabayashi T, Gotoda T, Kondo H, Inui T, Ono H, Saito D, et al. Early carcinoma of the gastric cardia in Japan: is it different from that in the West? Cancer. 2000;89(12):2555–9. 11135215.

29. Kim JY, Lee HS, Kim N, Shin CM, Lee SH, Park YS, et al. Prevalence and clinicopathologic characteristics of gastric cardia cancer in South Korea. Helicobacter. 2012;17(5):358–68. doi: 10.1111/j.1523-5378.2012.00958.x 22967119.

30. Kim EH, Park JC, Song IJ, Kim YJ, Joh DH, Hahn KY, et al. Prediction model for non-curative resection of endoscopic submucosal dissection in patients with early gastric cancer. Gastrointest Endosc. 2017;85(5):976–83. doi: 10.1016/j.gie.2016.10.018 27756614.

31. Kim SJ, Choi CW, Kang DH, Kim HW, Park SB, Nam HS, et al. Preoperative predictors of beyond endoscopic submucosal dissection indication or lymphovascular invasion in endoscopic resection for early gastric cancer. Surg Endosc. 2017. doi: 10.1007/s00464-017-6009-8 29280013.

32. Okada K, Fujisaki J, Kasuga A, Omae M, Yoshimoto K, Hirasawa T, et al. Endoscopic ultrasonography is valuable for identifying early gastric cancers meeting expanded-indication criteria for endoscopic submucosal dissection. Surg Endosc. 2011;25(3):841–8. doi: 10.1007/s00464-010-1279-4 20734082.

33. Kikuchi D, Iizuka T, Hoteya S, Yamada A, Furuhata T, Yamashita S, et al. Usefulness of magnifying endoscopy with narrow-band imaging for determining tumor invasion depth in early gastric cancer. Gastroenterology research and practice. 2013;2013:217695. doi: 10.1155/2013/217695 23401676; PubMed Central PMCID: PMC3562685.

34. Choi YY, Kim SJ, Choi CW, Kang DH, Kim HW, Park SB, et al. Risk Factors of Submucosal or Lymphovascular Invasion in Early Gastric Cancer <2 cm. Medicine (Baltimore). 2016;95(22):e3822. doi: 10.1097/MD.0000000000003822 27258528; PubMed Central PMCID: PMC4900736.

35. Pickhardt PJ, Asher DB. Wall thickening of the gastric antrum as a normal finding: multidetector CT with cadaveric comparison. AJR Am J Roentgenol. 2003;181(4):973–9. Epub 2003/09/23. doi: 10.2214/ajr.181.4.1810973 14500212.

36. Huh CW, Jung DH, Kim H, Kim H, Youn YH, Park H, et al. Clinicopathologic features of gastric carcinoma with lymphoid stroma in early gastric cancer. J Surg Oncol. 2016;114(6):769–72. doi: 10.1002/jso.24385 27450278.

37. Jang JH, Beron RI, Ahn HS, Kong SH, Lee HJ, Kim WH, et al. Clinicopathological Features of Upper Third Gastric Cancer during a 21-Year Period (Single Center Analysis). J Gastric Cancer. 2010;10(4):212–8. doi: 10.5230/jgc.2010.10.4.212 22076188; PubMed Central PMCID: PMC3204506.

38. Park JY, Ryu KW, Eom BW, Yoon HM, Kim SJ, Cho SJ, et al. Proposal of the surgical options for primary tumor control during sentinel node navigation surgery based on the discrepancy between preoperative and postoperative early gastric cancer diagnoses. Annals of surgical oncology. 2014;21(4):1123–9. Epub 2013/12/25. doi: 10.1245/s10434-013-3427-2 24366418.

39. Park HS, Lee SY, Hong SN, Kim JH, Sung IK, Park HS, et al. Early Gastric Cancer-Like Advanced Gastric Cancer versus Advanced Gastric Cancer-Like Early Gastric Cancer. Clin Endosc. 2013;46(2):155–60. doi: 10.5946/ce.2013.46.2.155 23614125; PubMed Central PMCID: PMC3630309.


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