Hye Kyung Jeon1, Seong Jun Lee2, Gwang Ha Kim3, Do Youn Park4, Bong Eun Lee1, Geun Am Song1. 1. Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-Gu, Busan, 49241, Republic of Korea. 2. Department of Internal Medicine, Joeun Gumgang Hospital, 1814-37 Gimhae-daero, Gimhae-si, Gyeongsangnam-do, Republic of Korea. 3. Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-Gu, Busan, 49241, Republic of Korea. doc0224@pusan.ac.kr. 4. Department of Pathology, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-Gu, Busan, 49241, Republic of Korea.
Abstract
BACKGROUND AND AIMS: Application of endoscopic submucosal dissection (ESD) for undifferentiated-type early gastric cancers (EGCs) remains controversial owing to limited data regarding long-term outcomes. We aimed to evaluate the feasibility of ESD for undifferentiated-type EGCs that meet the expanded criteria (EC). METHODS: We performed a retrospective analysis of 66 patients who underwent ESD for undifferentiated-type EGC between January 2005 and December 2014. We evaluated the rates of en bloc, complete, and curative resections along with overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS). RESULTS: Of the 66 patients, the EC group included 38 patients and the beyond-EC group included 28 patients. The overall rates of en bloc, complete, and curative resection of the 66 lesions were 92.4% (61/66), 65.2% (43/66), and 48.5% (32/66), respectively. Of the 34 patients with non-curative resection, 18 underwent additional surgery. Local remnant cancer was detected in 1 patient (1/18, 5.6%), and none of the 18 patients had lymph node metastasis. On multivariate analysis, tumors > 2 cm [odd ratio (OR) 6.183, 95% confidence interval (CI) 1.279-29.880, p = 0.023) and submucosal invasion depth (OR 6.226, 95% CI 1.881-20.606, p = 0.003) were independent predictors of incomplete resection. All 26 patients with more than 1 year of follow-up after curative resection survived without any evidence of local or distant recurrences over a median follow-up period of 36 months. The OS, DSS, and RFS rates of patients with curative ESD were 93.8, 100, and 100%, respectively. CONCLUSIONS: ESD may have favorable long-term outcomes in patients with undifferentiated-type EGC after curative resection.
BACKGROUND AND AIMS: Application of endoscopic submucosal dissection (ESD) for undifferentiated-type early gastric cancers (EGCs) remains controversial owing to limited data regarding long-term outcomes. We aimed to evaluate the feasibility of ESD for undifferentiated-type EGCs that meet the expanded criteria (EC). METHODS: We performed a retrospective analysis of 66 patients who underwent ESD for undifferentiated-type EGC between January 2005 and December 2014. We evaluated the rates of en bloc, complete, and curative resections along with overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS). RESULTS: Of the 66 patients, the EC group included 38 patients and the beyond-EC group included 28 patients. The overall rates of en bloc, complete, and curative resection of the 66 lesions were 92.4% (61/66), 65.2% (43/66), and 48.5% (32/66), respectively. Of the 34 patients with non-curative resection, 18 underwent additional surgery. Local remnant cancer was detected in 1 patient (1/18, 5.6%), and none of the 18 patients had lymph node metastasis. On multivariate analysis, tumors > 2 cm [odd ratio (OR) 6.183, 95% confidence interval (CI) 1.279-29.880, p = 0.023) and submucosal invasion depth (OR 6.226, 95% CI 1.881-20.606, p = 0.003) were independent predictors of incomplete resection. All 26 patients with more than 1 year of follow-up after curative resection survived without any evidence of local or distant recurrences over a median follow-up period of 36 months. The OS, DSS, and RFS rates of patients with curative ESD were 93.8, 100, and 100%, respectively. CONCLUSIONS: ESD may have favorable long-term outcomes in patients with undifferentiated-type EGC after curative resection.
Entities:
Keywords:
Early gastric cancer; Endoscopic submucosal dissection; Survival; Undifferentiated-type
Authors: K Okada; J Fujisaki; T Yoshida; H Ishikawa; T Suganuma; A Kasuga; M Omae; M Kubota; A Ishiyama; T Hirasawa; A Chino; M Inamori; Y Yamamoto; N Yamamoto; T Tsuchida; Y Tamegai; A Nakajima; E Hoshino; M Igarashi Journal: Endoscopy Date: 2012-01-23 Impact factor: 10.093
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: Byung-Hoon Min; Ki Joo Kang; Jun Haeng Lee; Eun Ran Kim; Yang Won Min; Poong-Lyul Rhee; Jae J Kim; Jong Chul Rhee; Kyoung-Mee Kim Journal: Dig Dis Sci Date: 2014-08-09 Impact factor: 3.199
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