Endoscopic submucosal dissection (ESD) was first
described as a non-surgical promise for early gastric
epithelial lesions

Antunes, A. G.

Contente, L.

Gago, T.

Guerreiro, H.

Queirós, P.

Roseira, Joana

Sousa, Helena Tavares

Vaz, A. M.

English

Sapientia

Esophageal and Gastric Cancer Initiative39 SERVIÇO: Radiology, Surgery AUTORES: Daniel Torres, Rita Camelo, Pedro Pegado, Pedro Men-donça, Luisa Quaresma, João Sacadora, Vasco Vas-concelos, Gualdino Silva, Gonçalo Fernandez, Jorge Esteves, Mário Oliveira, Lígia Costa CONTACTO: Rui Mateus Marques EMAIL: mateusmarques.rui@gmail.comABSTRACT ID: EG8151094 TÍTULO: The role of histology and tumor site in downstaging after neoadjuvant chemotherapy of gastric cancer patients OBJECTIVO/ INTRODUÇÃO: Neoadjuvant chemotherapy for gastric cancer has been the standard of care in many centers and downstaging after treatment is a major prognostic factor. The aim of this study was to identify preoperative predictors of pa-thological downstaging.MATERIAL E  MÉTODOS: This is a retrospective study that included 168 gastric cancer patients treated with neoadjuvant chemothera-py followed by surgery in a single cancer center be-tween 2007 and 2014. Exclusion criteria were: gastric stump tumors, associated esophagectomy, preoperati-ve radiotherapy and previously-diagnosed M1 disease. Pathological downstaging was defined as ypT0-1-2 or stage I tumors. RESULTADOS: Preoperative staged tumors were cT3-4 N+ in 80 cases, cT3-4 N0 in 73 and cT1-T2 N+ in 15 patients. Downsta-ged ypT0-1-2 lesions were observed in 74 patients, 19 individuals had pathological complete response (PCR) (11.3%) and another 35 had stage I tumors. Only tumor site was associated with more ypT0-1-2 tumors, which was more frequent in body and antrum lesions. Age, gender, preoperative clinical staging, histology, chemo-therapy regimen and completeness of treatment had no influence. When mixed-type cases were excluded, an interaction between tumor site and Lauren histology also proved to be a prognostic factor of downstaging, as PCR and stage I tumors were more frequent in distal intes-tinal-type lesions (50%) in comparison with the others. DISCUSSÃO: Downstaging was related to tumor site and histology and was more frequent in patients with distal intestinal--type tumors.HOSPITAL: A. C. Camargo Cancer Center SERVIÇO: Cirurgia Abdominal, A. C. Camargo Cancer Center (1), Oncologia Clínica, A. C. Camargo Cancer Center (2), Patologia Cirúrgica, A. C. Camargo Cancer Center (3) AUTORES: Costa Jr, WL (1), Ribeiro HSC (1), Diniz AL (1), Godoy AL (1), Farias IC (1), Cury Filho AM (1), Fonseca VH (2), Freitas HC (2), Mello CAL (2), Begnami MDFS (3), Coimbra FJF (1) CONTACTO: Wilson Luiz da Costa Jr EMAIL: dr.wilsoncosta@gmail.comABSTRACT ID: EG3368613 TÍTULO: Today, In The Endoscopist Hands OBJECTIVO/ INTRODUÇÃO: Endoscopic submucosal dissection (ESD) was first described as a non-surgical promise for early gastric epithelial lesions. Over time, ESD applications have ex-panded. In this context, authors present a case/icono-graphy and make brief discussion regarding ESD as an established modality for curative resection of selected gastrointestinal (GI) lesions.MATERIAL E  MÉTODOS: 75 year-old female patient referred to gastroenterolo-gy outpatient clinic for refractory dyspepsia. Objective and analytical examinations were unremarkable. Eso-phagogastroduodenoscopy (EGD) revealed atrophic mucosa at the antrum and a 10x15mm, Paris 0-IIa, flat lesion at the lesser curvature of the lower gastric body. Biopsies revealed: Intestinal metaplasia and chronic active gastritis, both associated to Helicobacter pylo-ri (HP); tubular low-grade dysplasia adenoma on the identified flat lesion. RESULTADOS: Patient was referred to a high-volume ESD centre whe-re endoscopic resection allowed an en block removal of the lesion. Diagnosis (WHO): High-grade intraepi-thelial neoplasia; Vienna Classification: Category 4.1; Staging (AJCC): pTis R0. One year endoscopic/histolo-gical follow-up showed no residual lesions. The patient achieved successful HP eradication. DISCUSSÃO: This case’s interest is twofold: Points out the role of EGD for (pre)malignant gastric lesions screening on a both HP and gastric cancer high prevalence country; highlights ESD applied for adequate curative non-surgi-cal resection of GI lesions by trained professionals.HOSPITAL: Centro Hospitalar do Algarve - Unidade de Portimão SERVIÇO: Serviço de Gastrenterologia -Centro Hospitalar do Al-garve AUTORES: Roseira J., Sousa HT., Queirós P., Antunes AG., Vaz AM., Gago T., Contente L., Guerreiro H. CONTACTO: Joana Roseira EMAIL: jsr_roseira@hotmail.comABSTRACT ID: EG1388047 TÍTULO: Treatment of Gastric Cancer: outcomes and survi-val analysis in patients submitted to gastrectomy OBJECTIVO/ INTRODUÇÃO: Gastric cancer (GC) is the 5th most frequently diag-nosed cancer and the 3rd cause of death from cancer worldwide. The objectives of this study were to analyze the characteristics, treatment options and overall sur-vival (OS) of the patients with GC, operated between January 2009 and December 2010.MATERIAL E  MÉTODOS: Retrospective analysis of the clinical records of the pa-tients with GC in which a gastrectomy with curative in-tent was performed. RESULTADOS: 51 patients operated. 33 (65%) were men. Median age of 70.6. Most common topographies: antrum (63%), body (16%) and fundus (10%). All tumors were adeno-carcinomas. According to Lauren Classification, 67% were intestinal and 33% diffuse type. 65% were at stage IB, IIA or IIB. In 69% a partial gastrectomy was performed; in those 86% had a Billroth II anastomosis. 94% did a D1 lymphadenectomy. Overall 30-day posto-perative mortality of 13,7%. 12% received neoadjuvant and adjuvant chemotherapy with MAGIC protocol and 39% postoperative chemoradiation with Macdonald regimen. 21,6% had disease recurrence. The most common sites of metastasis were the liver (55%) and peritoneum (36%). The OS at 5 years was 65%.

Today, in the endoscopist hands

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Today, in the endoscopist hands

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