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Relevant risk factors for positive lateral margin after en bloc endoscopic submucosal dissection for early gastric adenocarcinoma
Author(s) -
Fu Qing Yan,
Cui Yun,
Li Xiao Bo,
Chen Ping,
Chen Xiao Yu
Publication year - 2016
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12342
Subject(s) - medicine , lymphovascular invasion , univariate analysis , stomach , resection margin , adenocarcinoma , endoscopic submucosal dissection , multivariate analysis , gastroenterology , incidence (geometry) , gastric carcinoma , radiology , surgery , cancer , resection , metastasis , physics , optics
Objective This study aimed to systematically assess the relevant risk factors of positive lateral margin (LM) after en bloc resection of early gastric adenocarcinoma. Methods A total of 242 patients who had undergone endoscopic submucosal dissection (ESD) due to early gastric lesions from January 2009 to March 2015 were included in the study. Clinicopathological features of the lesions and the risk factors related to positive LM were analyzed. Results The curative rate was 82.2% and positive LM was found in 12.4% of the lesions. Univariate analysis showed that positive LM was significantly associated with the tumor location (at the upper third of the stomach), size (>3 cm), histological findings, the presence of lymphovascular invasion and deeper invasion depth. Moreover, positive LM had a higher incidence of recurrent or residual tumors. A multivariate analysis showed that the location, tumor size and histological classification of tumors were independent risk factors for positive LM. Conclusions Positive LM is closely related to the upper third of stomach, a tumor larger than 3 cm and a mixed‐type carcinoma. Additionally, positive LM has a predilection for recurrent or residual tumors.