Short-Term Outcomes of Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer: A Prospective Multicenter Cohort Study.
- Author:
Il Ju CHOI
1
;
Na Rae LEE
;
Sang Gyun KIM
;
Wan Sik LEE
;
Seun Ja PARK
;
Jae J KIM
;
Jun Haeng LEE
;
Jin Won KWON
;
Seung Hee PARK
;
Ji Hye YOU
;
Ji Hyun KIM
;
Chul Hyun LIM
;
Joo Young CHO
;
Gwang Ha KIM
;
Yong Chan LEE
;
Hwoon Yong JUNG
;
Ji Young KIM
;
Hoon Jai CHUN
;
Sang Yong SEOL
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Stomach neoplasms; Endoscopy; gastrointestinal; Outcome assess; Prospective studies
- MeSH: Cohort Studies*; Endoscopy; Follow-Up Studies; Hemorrhage; Hospitals, University; Humans; Lymph Nodes; Neoplasm Metastasis; Prospective Studies*; Retrospective Studies; Stomach Neoplasms*; Ulcer
- From:Gut and Liver 2016;10(5):739-748
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastric cancer (EGC) that has demonstrated a minimal risk of lymph node metastasis in retrospective studies. We sought to prospectively evaluate the short-term outcomes of ESD treatment in EGCs. METHODS: A prospective multicenter cohort study of neoplasms 3 cm or less in diameter at endoscopic size evaluation was performed in 12 Korean ESD study group-related university hospitals and the National Cancer Center. Resected specimens were evaluated by the central pathologic review board. RESULTS: A patient cohort (n=712) with a total of 737 EGCs was analyzed. The margin-freeen bloc resection rate was 97.3%, and curative resection of 640 lesions (86.8%) was achieved. Lower curative resection rates were associated with lesions 2 to 3 cm in size prior to ESD compared with lesions 2 cm or less in size (78.6% vs 88.1%, respectively, p=0.009). Significant factors associated with noncurative resection were moderately or poorly differentiated histological type, posterior wall tumor location, tumor size larger than 3 cm, ulceration, and submucosal invasion. Delayed bleeding occurred in 49 patients (6.9%), and 12 patients (1.7%) exhibited perforations. CONCLUSIONS: ESD is an effective treatment with a high curative resection rate for EGCs that meets relatively conservative pre-ESD indications. Long-term survival outcomes should be evaluated in follow-up studies.
