Long-Term Efficacy of Endoscopic Submucosal Dissection Compared with Surgery for Early Gastric Cancer: A Retrospective Cohort Study.
- Author:
Dae Yong KIM
1
;
Su Jin HONG
;
Gyu Seok CHO
;
Gui Ae JEONG
;
Hee Kyung KIM
;
Jae Pil HAN
;
Yun Nah LEE
;
Bong Min KO
;
Moon Sung LEE
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Endoscopic submucosal dissection; Gastrectomy; Long-term outcome; Indication
- MeSH: Adult; Aged; Dissection; Early Detection of Cancer; *Endoscopy, Gastrointestinal; Female; *Gastrectomy; Gastric Mucosa/*surgery; Humans; Length of Stay; Male; Middle Aged; Neoplasm Recurrence, Local/epidemiology; Patient Safety; Retrospective Studies; Stomach Neoplasms/*surgery/therapy; Treatment Outcome
- From:Gut and Liver 2014;8(5):519-525
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: This study aimed to compare the outcomes of endoscopic submucosal dissection (ESD) and gastrectomy based on the two sets of indications for ESD, namely guideline criteria (GC) and expanded criteria (EC). METHODS: Between January 2004 and July 2007, 213 early gastric cancer (EGC) patients were enrolled in this study. Of these patients, 142 underwent ESD, and 71 underwent gastrectomy. We evaluated the clinical outcomes of these patients according to the criteria. RESULTS: The complication rates in the ESD and gastrectomy groups were 8.5% and 28.2%, respectively. The duration of hospital stay was significantly shorter in the ESD group than the gastrectomy group according to the GC and EC (p<0.001 and p<0.001, respectively). There was no recurrence in the ESD and gastrectomy groups according to the GC, and the recurrence rates in the ESD and gastrectomy groups were 4.7% and 0.0% according to the EC, respectively (p=0.279). The occurrence rates of metachronous cancer in the ESD and gastrectomy groups were 5.7% and 5.0% according to the GC (p=1.000) and 7.5% and 0.0% according to the EC (p=0.055), respectively. CONCLUSIONS: Based on safety, duration of hospital stay, and long-term outcomes, ESD may be an effective and safe first-line treatment for EGC according to the EC and GC.