Jeongmin Choi1, Sang Gyun Kim, Jong Pil Im, Joo Sung Kim, Hyun Chae Jung. 1. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Yongun-dong 28, Chongno-gu, Seoul, 110-744, South Korea, doct00@hanmail.net.
Abstract
BACKGROUND: We aimed to evaluate long-term clinical outcomes of endoscopic resection for early gastric cancer (EGC). PATIENTS AND METHODS: From 2005 through 2011, 961 patients with EGC were treated with endoscopic submucosal dissection (ESD). Patients were grouped as standard and expanded criteria, while those who did not meet the expanded criteria were regarded as the group beyond the expanded criteria. Complete resection rate and the long-term clinical outcomes were compared among the three groups. RESULTS: Complete resection rate was significantly higher in the standard group than in expanded and beyond the expanded group; 96.1% for standard, 92.5% for expanded, 55.5% for beyond the expanded indication group. During a mean follow-up of 42 months, local tumor recurrence developed more frequently in beyond the expanded group (7.8%) than in the standard and expanded group (1.8%). Metachronous cancer incidence (6.5%) did not differ significantly between the three groups. Two-thirds of recurred or metachronous tumors were treated with additional ESD. Lymph node metastasis developed in 0.6%. Five-year overall survival rate was 94.8% (96.6% for standard, 94.2% for expanded, 84.4% for beyond expanded, P < 0.001) and disease-free survival rate was 99.1% (100, 99.3, 92.8%, respectively, P < 0.001). CONCLUSIONS: Endoscopic resection for EGC showed favorable long-term clinical outcomes in the patients within the standard and expanded criteria, whereas less favorable clinical outcomes in the patients beyond the expanded criteria.
BACKGROUND: We aimed to evaluate long-term clinical outcomes of endoscopic resection for early gastric cancer (EGC). PATIENTS AND METHODS: From 2005 through 2011, 961 patients with EGC were treated with endoscopic submucosal dissection (ESD). Patients were grouped as standard and expanded criteria, while those who did not meet the expanded criteria were regarded as the group beyond the expanded criteria. Complete resection rate and the long-term clinical outcomes were compared among the three groups. RESULTS: Complete resection rate was significantly higher in the standard group than in expanded and beyond the expanded group; 96.1% for standard, 92.5% for expanded, 55.5% for beyond the expanded indication group. During a mean follow-up of 42 months, local tumor recurrence developed more frequently in beyond the expanded group (7.8%) than in the standard and expanded group (1.8%). Metachronous cancer incidence (6.5%) did not differ significantly between the three groups. Two-thirds of recurred or metachronous tumors were treated with additional ESD. Lymph node metastasis developed in 0.6%. Five-year overall survival rate was 94.8% (96.6% for standard, 94.2% for expanded, 84.4% for beyond expanded, P < 0.001) and disease-free survival rate was 99.1% (100, 99.3, 92.8%, respectively, P < 0.001). CONCLUSIONS: Endoscopic resection for EGC showed favorable long-term clinical outcomes in the patients within the standard and expanded criteria, whereas less favorable clinical outcomes in the patients beyond the expanded criteria.
Authors: Ji Yong Ahn; Hwoon-Yong Jung; Kee Don Choi; Ji Young Choi; Mi-Young Kim; Jeong Hoon Lee; Kwi-Sook Choi; Do Hoon Kim; Ho June Song; Gin Hyug Lee; Jin-Ho Kim; Young Soo Park Journal: Gastrointest Endosc Date: 2011-07-13 Impact factor: 9.427
Authors: H Isomoto; S Shikuwa; N Yamaguchi; E Fukuda; K Ikeda; H Nishiyama; K Ohnita; Y Mizuta; J Shiozawa; S Kohno Journal: Gut Date: 2008-11-10 Impact factor: 23.059
Authors: Sang Gyun Kim; Chan Mi Park; Na Rae Lee; Jiyoung Kim; Da Hyun Lyu; Seung-Hee Park; Il Ju Choi; Wan Sik Lee; Seun Ja Park; Jae Jun Kim; Ji Hyun Kim; Chul-Hyun Lim; Joo Young Cho; Gwang Ha Kim; Yong Chan Lee; Hwoon-Yong Jung; Jun Haeng Lee; Hoon Jai Chun; Sang-Yong Seol Journal: Gut Liver Date: 2018-07-15 Impact factor: 4.519