Gastric cancer. EndoTODAY

[Gastric cancer 804. ESD for cardia cancer in the remnant stomach - pathologically non-curative resection]

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ESD for a cardia cancer in the remnant stomach (female 75) was done. Because of the location, the procedure was difficult but successful. However, the pathology was non-curative resection. How would you recommend?

ESD: Early gastric carcinoma
1. Location : cardia
2. Gross type : EGC type IIb
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 20 mm (2) vertical diameter, 12 mm
6. Depth of invasion : invades submucosa, (depth of sm invasion : 2500 ) (pT1b)
7. Resection margin : involved deep resection margin by carcinoma; safety margin : distal 1 mm, proximal 4 mm, anterior 1 mm, posterior 4 mm, deep 0
8. Lymphatic invasion : present
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Pre-existing adenoma : none
12. Microscopic ulcer : absent
13. Histologic heterogeneity: absent

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