Long-Term Clinical Outcomes of Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer: A Prospective Multicenter Cohort Study.
- Author:
Sang Gyun KIM
1
;
Chan Mi PARK
;
Na Rae LEE
;
Jiyoung KIM
;
Da Hyun LYU
;
Seung Hee PARK
;
Il Ju CHOI
;
Wan Sik LEE
;
Seun Ja PARK
;
Jae Jun KIM
;
Ji Hyun KIM
;
Chul Hyun LIM
;
Joo Young CHO
;
Gwang Ha KIM
;
Yong Chan LEE
;
Hwoon Yong JUNG
;
Jun Haeng LEE
;
Hoon Jai CHUN
;
Sang Yong SEOL
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Survival; Endoscopic mucosal dissection; Stomach neoplasms
- MeSH: Academies and Institutes; Cohort Studies*; Follow-Up Studies; Humans; Korea; Neoplasm Metastasis; Pathology; Prospective Studies*; Recurrence; Stomach Neoplasms*; Survival Rate
- From:Gut and Liver 2018;12(4):402-410
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has been regarded as a curative treatment for early gastric cancer (EGC) in indicated cases. The aim of this study was to evaluate the nationwide long-term clinical outcomes of ESD for EGC in Korea. METHODS: A prospective multicenter cohort study was performed to evaluate the long-term efficacy of ESD for EGC within pre-defined indications at 12 institutes in Korea. The cases that met the expanded criteria upon pathological review after ESD were followed for 5 years. The primary outcome was 5-year disease specific free survival. RESULTS: Six hundred ninety-seven patients with 722 EGCs treated with ESD were prospectively enrolled and followed for 5 years. Complete resection was achieved in 81.3% of the cases, and curative resection was achieved in 86.1%. During the 5-year follow-up, the overall survival rate was 96.6%, and the disease specific free survival rate was 90.6%. Local recurrence developed in 0.9%, and metachronous tumor development occurred in 7.8%; both conditions were treated by endoscopic or surgical treatment. Distant metastasis developed in 0.5% during follow-up. CONCLUSIONS: ESD showed excellent long-term clinical outcomes and can be accepted as a curative treatment for patients with EGC who meet the expanded criteria in final pathology studies.
