Recurrence after ESD curative resection for early gastric cancer

Abstract Background Endoscopic submucosal dissection (ESD) is gaining ground as a minimally invasive treatment for early gastric cancer (EGC) that has a negligible risk of lymph node metastasis. According to the 5th edition of Japanese gastric cancer treatment guidelines, annual or biannual follow-u...

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Main Authors: Ayako Kamiya, Hitoshi Katai, Kenichi Ishizu, Takeyuki Wada, Tsutomu Hayashi, Sho Otsuki, Yukinori Yamagata, Takaki Yoshikawa, Shigeki Sekine, Tomohiko Nishi, Yuka Kawasaki, Takafumi Ito, Hideharu Domoto
Format: Article
Language:English
Published: Japan Surgical Society 2021-01-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-020-01089-0
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author Ayako Kamiya
Hitoshi Katai
Kenichi Ishizu
Takeyuki Wada
Tsutomu Hayashi
Sho Otsuki
Yukinori Yamagata
Takaki Yoshikawa
Shigeki Sekine
Tomohiko Nishi
Yuka Kawasaki
Takafumi Ito
Hideharu Domoto
author_facet Ayako Kamiya
Hitoshi Katai
Kenichi Ishizu
Takeyuki Wada
Tsutomu Hayashi
Sho Otsuki
Yukinori Yamagata
Takaki Yoshikawa
Shigeki Sekine
Tomohiko Nishi
Yuka Kawasaki
Takafumi Ito
Hideharu Domoto
author_sort Ayako Kamiya
collection DOAJ
description Abstract Background Endoscopic submucosal dissection (ESD) is gaining ground as a minimally invasive treatment for early gastric cancer (EGC) that has a negligible risk of lymph node metastasis. According to the 5th edition of Japanese gastric cancer treatment guidelines, annual or biannual follow-up with endoscopy is recommended, but follow-up with abdominal ultrasonography or computed tomography (CT) for surveillance of metastases is not recommended after the eCuraA resection. However, we experienced a case of lymph node recurrence following ESD resulting in eCuraA. Case presentation A 76-year-old female received ESD for EGC in a previous hospital 4 years ago. Pathological findings were tub1, 30 mm, T1a (M), UL0, Ly0, V0, pHM-, pVM- (eCuraA) according to the 15th edition of Japanese Classification of Gastric Carcinoma. Follow-up esophagogastroduodenoscopy revealed submucosal tumor, which was suspected as a swollen lymph node by CT and endoscopic ultrasound fine-needle aspiration revealed the recurrence of gastric cancer. We performed total gastrectomy with D2 lymph node dissection. Postoperative pathological examination revealed no local recurrent tumor at the ESD site in the stomach. Swollen lymph node was diagnosed as metastasis and lymph node metastasis was limited near the cardia. Conclusion This case provides valuable information about tumor with a minimum poorly differentiated adenocarcinoma component may develop lymph node metastasis even satisfying the guidelines criteria for curative resection.
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spelling doaj-art-1819a9108fc34a8bb8ddccf0becce7aa2025-08-20T03:15:10ZengJapan Surgical SocietySurgical Case Reports2198-77932021-01-01711410.1186/s40792-020-01089-0Recurrence after ESD curative resection for early gastric cancerAyako Kamiya0Hitoshi Katai1Kenichi Ishizu2Takeyuki Wada3Tsutomu Hayashi4Sho Otsuki5Yukinori Yamagata6Takaki Yoshikawa7Shigeki Sekine8Tomohiko Nishi9Yuka Kawasaki10Takafumi Ito11Hideharu Domoto12Department of Gastric Surgery, National Cancer Center HospitalDepartment of Gastric Surgery, National Cancer Center HospitalDepartment of Gastric Surgery, National Cancer Center HospitalDepartment of Gastric Surgery, National Cancer Center HospitalDepartment of Gastric Surgery, National Cancer Center HospitalDepartment of Gastric Surgery, National Cancer Center HospitalDepartment of Gastric Surgery, National Cancer Center HospitalDepartment of Gastric Surgery, National Cancer Center HospitalDepartment of Pathology, National Cancer Center HospitalDepartment of Surgery, Keiyu HospitalDepartment of Gastroenterology, Keiyu HospitalDepartment of Gastroenterology, Keiyu HospitalDepartment of Diagnostic Pathology, Keiyu HospitalAbstract Background Endoscopic submucosal dissection (ESD) is gaining ground as a minimally invasive treatment for early gastric cancer (EGC) that has a negligible risk of lymph node metastasis. According to the 5th edition of Japanese gastric cancer treatment guidelines, annual or biannual follow-up with endoscopy is recommended, but follow-up with abdominal ultrasonography or computed tomography (CT) for surveillance of metastases is not recommended after the eCuraA resection. However, we experienced a case of lymph node recurrence following ESD resulting in eCuraA. Case presentation A 76-year-old female received ESD for EGC in a previous hospital 4 years ago. Pathological findings were tub1, 30 mm, T1a (M), UL0, Ly0, V0, pHM-, pVM- (eCuraA) according to the 15th edition of Japanese Classification of Gastric Carcinoma. Follow-up esophagogastroduodenoscopy revealed submucosal tumor, which was suspected as a swollen lymph node by CT and endoscopic ultrasound fine-needle aspiration revealed the recurrence of gastric cancer. We performed total gastrectomy with D2 lymph node dissection. Postoperative pathological examination revealed no local recurrent tumor at the ESD site in the stomach. Swollen lymph node was diagnosed as metastasis and lymph node metastasis was limited near the cardia. Conclusion This case provides valuable information about tumor with a minimum poorly differentiated adenocarcinoma component may develop lymph node metastasis even satisfying the guidelines criteria for curative resection.https://doi.org/10.1186/s40792-020-01089-0Gastric cancerEndoscopic submucosal dissectionNeoplasm metastasisRecurrenceGastrectomy
spellingShingle Ayako Kamiya
Hitoshi Katai
Kenichi Ishizu
Takeyuki Wada
Tsutomu Hayashi
Sho Otsuki
Yukinori Yamagata
Takaki Yoshikawa
Shigeki Sekine
Tomohiko Nishi
Yuka Kawasaki
Takafumi Ito
Hideharu Domoto
Recurrence after ESD curative resection for early gastric cancer
Surgical Case Reports
Gastric cancer
Endoscopic submucosal dissection
Neoplasm metastasis
Recurrence
Gastrectomy
title Recurrence after ESD curative resection for early gastric cancer
title_full Recurrence after ESD curative resection for early gastric cancer
title_fullStr Recurrence after ESD curative resection for early gastric cancer
title_full_unstemmed Recurrence after ESD curative resection for early gastric cancer
title_short Recurrence after ESD curative resection for early gastric cancer
title_sort recurrence after esd curative resection for early gastric cancer
topic Gastric cancer
Endoscopic submucosal dissection
Neoplasm metastasis
Recurrence
Gastrectomy
url https://doi.org/10.1186/s40792-020-01089-0
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