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Article Abstract
Backgrounds: The clinical significance of subepithelial (SE) spread from early gastric cancer (EGC) is poorly understood. Thus, we evaluated the proportion and extent of SE spread from EGC, as well as related risk factors.
Methods: We reviewed medical records and pathological specimens from patients with EGC who underwent surgery or endoscopic resection between January 2016 and December 2016 at Chungnam National University Hospital.
Results: A total of 404 patients were reviewed and SE spread was identified for 142 patients (35.1%). The presence of SE spread was associated with gender, histological type, location, endoscopic appearance, color change, presence of lymphovascular invasion, and invasion depth. Multivariable analysis revealed that SE spread was only independently associated with histological type. The distance of SE spread was significantly different between histological types, and the maximum distance was 17 mm.
Conclusion: More than 30% of our patients with EGC had SE spread, which could reach up to 17 mm. Given the proportion of SE spread in these cases, a wider resection margin may be safe during endoscopic resection or surgery.
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| http://dx.doi.org/10.1007/s10120-021-01171-y | DOI Listing |
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Article Synopsis
- A 75-year-old woman was diagnosed with early-stage gastric cancer during an endoscopic examination, specifically a type 0-I carcinoma located on the middle part of her stomach.
- During the procedure, small whitish structures called white globe appearances (WGAs) were observed near the cancer area, indicating potential subepithelial cancer spread despite the surface appearing flat and noncancerous.
- Histopathology results confirmed the presence of cancer with significant lymphatic invasion, showing that the cancer had spread along the lymphatic vessels into surrounding tissues, which was likely responsible for the WGA characteristics seen during the endoscopy.