BACKGROUND: Endoscopic submucosal dissection (ESD) has been used to treat patients with early gastric cancers (EGCs), including large and ulcerative lesions. Few published data exist on the long-term outcomes of this treatment with median follow-up periods of over 5 years; we therefore aimed to assess the long-term outcomes of EGC patients undergoing ESD. METHODS: A total of 1,956 consecutive patients with 2,210 EGC lesions at initial onset underwent ESD with curative intent at our hospital from 1999 to 2006. We performed a retrospective analysis of the 5-year survival of EGC patients undergoing curative ESD for absolute indications or for expanded indications. RESULTS: For the pathological curability, curative ESD for absolute indications, curative ESD for expanded indications of differentiated-type EGC, and curative ESD for undifferentiated-type EGC were achieved in 781, 713, and 43 patients, respectively. The median follow-up period was 83.3 months. Among the 1,537 patients, there were only two patients with recurrence, including one who developed a regional lymph node (LN) metastasis and one who developed a distant LN metastasis with local recurrence resulting in gastric cancer-related death. Seven died from metachronous gastric cancers. The 5-year rates of overall survival, disease-specific survival, and relative survival were 92.6, 99.9, and 105.0%, respectively. CONCLUSIONS: Based on the high rate of 5-year survival among EGC patients undergoing curative ESD for absolute indications or for expanded indications in the largest patient series with a median follow-up period of over 5 years, ESD could be employed as a standard treatment for EGC lesions.
BACKGROUND: Endoscopic submucosal dissection (ESD) has been used to treat patients with early gastric cancers (EGCs), including large and ulcerative lesions. Few published data exist on the long-term outcomes of this treatment with median follow-up periods of over 5 years; we therefore aimed to assess the long-term outcomes of EGCpatients undergoing ESD. METHODS: A total of 1,956 consecutive patients with 2,210 EGC lesions at initial onset underwent ESD with curative intent at our hospital from 1999 to 2006. We performed a retrospective analysis of the 5-year survival of EGCpatients undergoing curative ESD for absolute indications or for expanded indications. RESULTS: For the pathological curability, curative ESD for absolute indications, curative ESD for expanded indications of differentiated-type EGC, and curative ESD for undifferentiated-type EGC were achieved in 781, 713, and 43 patients, respectively. The median follow-up period was 83.3 months. Among the 1,537 patients, there were only two patients with recurrence, including one who developed a regional lymph node (LN) metastasis and one who developed a distant LN metastasis with local recurrence resulting in gastric cancer-related death. Seven died from metachronous gastric cancers. The 5-year rates of overall survival, disease-specific survival, and relative survival were 92.6, 99.9, and 105.0%, respectively. CONCLUSIONS: Based on the high rate of 5-year survival among EGCpatients undergoing curative ESD for absolute indications or for expanded indications in the largest patient series with a median follow-up period of over 5 years, ESD could be employed as a standard treatment for EGC lesions.
Entities:
Keywords:
Early gastric cancer; Endoscopic submucosal dissection; Long-term outcomes; Recurrence
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: Michael J Mathers; Stephan Roth; Monika Klinkhammer-Schalke; Michael Gerken; Ferdinand Hofstaedter; Stefan Wilm; Theodor Klotz Journal: J Cancer Date: 2011-02-08 Impact factor: 4.207