A retrospective cohort study of the long-term effects of endoscopic submucosal dissection in treating early gastrointestinal cancer or precancerous lesions
10.3969/j.issn.1007-1989.2017.08.003
- VernacularTitle:内镜黏膜下剥离术治疗消化道早期癌及癌前病变长期疗效的单中心回顾性队列分析
- Author:
Jing DU
;
Yong HAN
;
Weiquan WU
;
Peng LI
;
Jianmin YANG
- Keywords:
endoscopic submucosal dissection;
early cancer;
precancerous lesion;
gastrointestinal
- From:
China Journal of Endoscopy
2017;23(8):13-17
- CountryChina
- Language:Chinese
-
Abstract:
Objective A retrospective cohort study was carried out to observe the long-term effect of ESD in treating early gastrointestinal cancer or precancerous lesions. Methods The clinical and follow-up data of 73 patients were collected. Kaplan-Meier, Log-rank and Breslow test and Cox's proportional hazards regression model were used to analyze the data. Results The median survival time in the gastric and colo-rectal early cancer or precancerous lesions is longer than 65 months in our study, respectively. For esophagus, the median survival time was 44.5 months; the disease free survival time (DFS) after ESD was significantly reduced in the esophagus, compared to the stomach and colo-rectum (χ2 = 12.61, P = 0.000; χ2 = 7.09, P = 0.008); the degree of atypia (or infiltration), and lesion size were considered to be two factors to influence the DFS after ESD (P = 0.027, OR^ =2.38, 95%CI:1.10 ~ 5.12, P = 0.074, 95%CI; OR^ =0.90, 95%CI: 0.80 ~ 1.01). Conclusion ESD is an effective curative treatment in the resection of early upper gastrointestinal cancer and precancerous lesions. The degree of atypia (or infiltration) was concluded as an independent risk factor for the DFS post-ESD, and the size of lesion was a valuable parameter with regard to the recurrence after ESD procedure.
