演題抄録

ポスター

開催概要
開催回
第56回・2018年・横浜
 

NET G1/G2の外科的切除基準の妥当性に対する臨床病理学的検討

演題番号 : P110-2

[筆頭演者]
演者)千田 圭悟:1 
[共同演者]
渡邉 純:1、池田 孝秀:1、福岡 宏倫:1、淺利 昌大:1、渡辺 卓央:1、柿添 学:1、諏訪 宏和:2、樅山 将士:3、石部 敦士:4、虫明 寛行:1、湯川 寛夫:1、大田 貢由:1、國崎 主税:1、遠藤 格:4

1:横浜市立大学附属市民総合医療センター・消化器病センター・外科、2:横須賀共済病院・外科、3:NTT東日本関東病院・外科、4:横浜市立大学附属病院・消化器腫瘍外科

 

Background and Aim:We verified the validity for the primary surgical indication and the additional surgical resection criteria after endoscopic resection(ER). Futhermore, we examined new factors additional surgical resection after ER. Patients and Method: We retrospectively analyzed the 109 cases of rectal NET G1/G2 between January 2000 and October 2017.In the case of tumor diameter>10mm, primary surgical resection was performed, and ER(EMR/ESD) was performed for the other cases.The criteria for additional surgical resection were 1.NET G2, 2.MP invasion, 3.ly/v(+), and vertical margin(+). Results:The numbers of NET G1/G2 were 101/8 cases, respectively.Clinicopathological factors were as follows;[age:57 vs.56],[tumor location(RS/Ra/Rb): 1/17/80 vs.1/0/5],[tumor size(mm):7.7 vs.15.6,p=0.0001],[SM/MP/SS:107/2/0 vs.4/3/1],[pathological lymph node metastasis(pLNM): 11.8% vs.25%,p=0.27]. The therapy for NET G1/G2 was as follows;[surgical alone/ additional surgical resection after ER/ ER alone:16/23/48 vs.4/2/0]. When dividing NET G1 into two groups(<10mm vs.≧10mm), pLNM rate was(4.0% vs.36%,p=0.0002). In the cases of the tumor diameter <10mm, pLNM rate of ly(-vs. +),v(-vs. +), and MP invasion(-vs. +) were as follows; ly(-:3.3%vs. +:11%,p=0.38)and v(-:1.6% vs.22%,p=0.04), respectively.Only a case has MP invasion, and there was'nt pLNM. So, dividing NETG1/G2<10mm into two groups by pSM invasion distance(<2250um n=20 vs.≧2250 n=15),pLNM rate was(0% vs.13.3%,p=0.18).Conclusion:Our results suggests that the primary surgical resection for ≧10mm NET is reasonable and lateral lymph node dissection is unnecessary.And because pLNM rate>10% was in the case of NET G2 and ly/v(+),these seem to be valid as the criteria for additional surgical.Indeed the MP invasion is not wrong as a criteria for additional surgical resection, but NET(G1/G2)<10mm hardly infiltrate to MP, as a new criteria of additional surgical resection, the pSM invasion distance(ex ≧2250um) might need to be considerd.

前へ戻る