GIPS/AGPS Pathological assessment of EMR/ESD

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  • #13745

    Nice review, thank you very much for doing this for all of us.
    My comment is in regard to what my clinicians ask me everyday. What is the risk for node metastasis in my patient with EMR/ESD invasive carcinoma?
    You have summarized in Table 1 the risk of node metastasis in SM1, SM2, and SM3 categories (Resection specimens!!) . However, you correctly recommend to report the depth of invasion in the SM in microns. Now can you tell me how many microns is equivalent to a SM1 lesion? and what about a SM2 and above how many microns for SM3?. If we need to report in microns we should assess the risk (low/medium/high for example) or (<than ????microns=2-5% risk), between (??? microns and ????microns) = 24% risk) and so on….
    This should be specific for each GI organ examined. If you want to assess the risk with traditional SM categories

    Finally, is everybody OK that in the absence of MM for example in esophageal and colon carcinoma we should measure from the surface of the malignant polyp? I my opinion, and also as some papers have mentioned, this method overestimate depth and potentially we are going to perform more unnecessary surgical procedures.

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