A retrospective study of endoscopic treatment on early gastric cancer in a single center for 10 years
10.3760/cma.j.issn.1007-5232.2018.04.002
- VernacularTitle:单中心10年间早期胃癌内镜下治疗的回顾性研究
- Author:
Long ZOU
1
;
Xi WU
;
Aiming YANG
;
Jieyao CHENG
;
Fang YAO
;
Weixun ZHOU
;
Tao GUO
;
Dongsheng WU
;
Qingwei JIANG
;
Yunlu FENG
;
Yimin LI
;
Xinghua LU
Author Information
1. 中国医学科学院北京协和医学院 北京协和医院消化内科
- Keywords:
Stomach neoplasms;
Endoscopic mucosal resection;
Endoscopic submucosal dissection;
Indication;
Curative resection
- From:
Chinese Journal of Digestive Endoscopy
2018;35(4):234-239
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy, safety and risk factors of endoscopic treatment for patients with early gastric cancer. Methods A retrospective study was conducted in a single center and data was collected from 186 early gastric cancers in 168 pathologically confirmed patients who received endoscopic treatment in Peking Union Medical College Hospital from January 2006 to December 2015. The cases were divided into different groups according to indications of endoscopic treatment. The curative resection rate and complication rate were analyzed. Post-resection outcomes were evaluated by long-term surveillance. Results The curative resection rate was 86. 9%( 73/84) in the group with absolute indications, 61. 7%(50/81)in the group with expanded indications, and 33. 3%(7/21) in the group beyond indications (P＜0. 01). Multivariate analysis revealed that the significant independent predictors for curative resection included lower third location of stomach, no ulceration,≤2 cm at diameter, no adhesion, and well-differentiation in histopathology. In the expanded indications group, discordance of differentiation type and deeper invasion mainly resulted in non-curative resection in en bloc lesions. The rate of bleeding and perforation was 4. 8%( 9/186) and 3. 8%( 7/186), respectively. The perforation rate was significantly lower in the lesions located in the lower third of stomach, without adhesion or performed by en bloc resection. During a median follow-up period of 22. 3 months, 154 patients were followed successfully. The incidence of synchronous and metachronous gastric cancers in curative resected lesions was 7. 5%( 8/106) and 0. 9%(1/106), respectively. Conclusion Endoscopic resection is an optimal treatment with high curative resection rate for early gastric cancer patients with absolute indications. Patients with expanded indications should take precise preoperative evaluation to avoid higher risk of non-curative resection endoscopically. Close follow-up is necessary for synchronous and metachronous gastric cancers after endoscopic resection.
