EGC expanded indication. EndoTODAY 이준행

[Gastric cancer 873. Expanded indication EGC]

001 | 101 | 201 | 301 | 401 | 501 | 601 | 701 | 801 | 901 | 1000

Would you ESD?

It should be an EGC. Although ulcer is not definite, some areas were depressed. And the size is at least 4cm. So I recommended surgery.

Stomach, radical subtotal gastrectomy: Early gastric carcinoma
1. Location : middle third, Center at angle and antero-lesser curvature
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size : 5.0x2.5 cm
6. Depth of invasion : invades mucosa (muscularis mucosae) (pT1a)
7. Resection margin: free from carcinoma, safety margin: proximal 3.0 cm, distal 7.1 cm
8. Lymph node metastasis : no metastasis in 33 regional lymph nodes (pN0) (0/33: 3,5, 0/12; 4,6, 0/8; "1", 0/0; "5", 0/1; "6", 0/1; "7", 0/2; "9", 0/3; "8a", 0/2; "11p", 0/0; "12a", 0/3; "4sb", 0/0; "3", 0/1; "4", 0/0)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. AJCC stage by 8th edition: pT1a N0

Mucosal cancer can be very large. I usually recommend surger for lesions larger than 4-5cm.