Pitfalls in the Interpretation of Publications about Endoscopic Submucosal Dissection of Early Gastric Cancer with Undifferentiated-Type Histology
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초록
Endoscopic submucosal dissection (ESD) is a standard treatment for patients with gastrointestinal neoplasms with a negligible risk oflymph node metastasis. ESD enables en bloc resection of gastrointestinal neoplasms and organ preservation, thereby, avoiding surgicaltreatment. Although small (<2 cm) intramucosal early gastric cancer with undifferentiated-type histology (EGC-UH) without ulcerationis included in the expanded criteria for ESD, controversies remain due to different biology and characteristics compared to EGC withdifferentiated-type histology. The authors previously presented studies about the technical feasibility of ESD for these lesions using ameta-analysis and retrospective multicenter analysis. However, many pitfalls were identified in the interpretation of studies analyzinghistologic discrepancy, mixed-type histology, criteria-based analysis of therapeutic outcomes, interpretation of curative resection, andlong-term clinical outcomes. In this review, the authors discuss pitfalls in the interpretation of publications on ESD for EGC-UH.
Abstract
Endoscopic submucosal dissection (ESD) is a standard treatment for patients with gastrointestinal neoplasms with a negligible risk oflymph node metastasis. ESD enables en bloc resection of gastrointestinal neoplasms and organ preservation, thereby, avoiding surgicaltreatment. Although small (<2 cm) intramucosal early gastric cancer with undifferentiated-type histology (EGC-UH) without ulcerationis included in the expanded criteria for ESD, controversies remain due to different biology and characteristics compared to EGC withdifferentiated-type histology. The authors previously presented studies about the technical feasibility of ESD for these lesions using ameta-analysis and retrospective multicenter analysis. However, many pitfalls were identified in the interpretation of studies analyzinghistologic discrepancy, mixed-type histology, criteria-based analysis of therapeutic outcomes, interpretation of curative resection, andlong-term clinical outcomes. In this review, the authors discuss pitfalls in the interpretation of publications on ESD for EGC-UH.
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