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Follow-up outcomes of endoscopic resection for early gastric cancer with undifferentiated histology



The application of endoscopic resection (ER) for undifferentiated-type early gastric cancer (UD-EGC) remains controversial. The aim was to examine long-term outcomes of ER for UD-EGC. Furthermore, we investigated whether long-term outcomes of ER differed between poorly differentiated adenocarcinoma (PD) and signet ring cell carcinoma (SRC).


From 2001 to 2011, 209 lesions in 209 patients with UD-EGC (82 PD; 127 SRC) were treated by ER. We retrospectively assessed the clinical outcomes of ER in 209 patients. The survival rate and disease-free survival rates after ER were evaluated as long-term outcomes.


The en bloc resection and curative resection (CR) rates were 91.4 and 55.0 %, respectively. The en bloc and CR rates in PD were 90.2 and 45.1 %, whereas those in SRC were 92.1 and 61.4 %. For patients with PD who underwent non-curative resections, 51.1 % were vertical-cut end-positive and for those with SRC, 63.3 % were lateral-cut end-positive, a statistically significant difference. In those patients where CR was achieved, no case of local recurrence or distant metastasis was observed during the follow-up period (32.7 ± 22.2 months). The 3- and 5-year survival rates were 99.0 and 98.6 %, with no significant difference between CR patients with SRC and PD.


ER may yield good long-term outcomes for UD-EGC if CR is achieved, with no difference between PD and SRC. However, to increase the current CR rate of ER, stricter criteria for performing ER in UD-EGC may be required.

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Drs. Jie-Hyun Kim, Yong Hoon Kim, Da Hyun Jung, Han Ho Jeon, Yong Chan Lee, Hyuk Lee, Sang Kil Lee, Jun Chul Park, Sung Kwan Shin, Young Hoon Youn, and Hyojin Park have no conflict of interest or financial ties to disclose.

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Correspondence to Yong Chan Lee.

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J.-H. Kim and Y.H. Kim contributed equally to this work.

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Kim, JH., Kim, Y.H., Jung, D.H. et al. Follow-up outcomes of endoscopic resection for early gastric cancer with undifferentiated histology. Surg Endosc 28, 2627–2633 (2014).

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  • Early gastric cancer
  • Undifferentiated
  • Endoscopic resection
  • Survival
  • Recurrence