[Ratio of multiple lateral margin (+) in ESD specimen]

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In our institution, lateral margin involvement is evaluated and reported in 4 directions. In about 14 hundred early gastric cancers treated by ESD, lateral margin involvement was documented in 5.2%. Among them, 60% were single lateral margin positive. 40% were multiple lateral margin positive.

Histologic heterogeneity was seen in 25% and 46%, respectively. Extremely well differentiated adenocarcinoma was 7% and 25% in the two groups. This difference was statistically significant. Cases of technical difficulty was the same in the two groups. Surprisingly, the procedure time was shorter in the multiple lateral margin positive group. We thought that the technical aspect was not related to the number of positive lateral margin.

In this figure, yellow bar is the proportion of the cases with HH or EWDA. It showed that the ratio of HH or EWDA is increasing according to the number of lateral margin positive direction. And the difference was statistically significant.