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KMID : 1188320160100050739
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Gut and Liver
2016 Volume.10 No. 5 p.739 ~ p.748
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Short-Term Outcomes of Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer: A Prospective Multicenter Cohort Study
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Choi Il-Ju
Kim Sang-Gyun
Lee Wan-Sik
Park Seun-Ja
Kim Jae-J
Lee Jun-Haeng
Kwon Jin-Won
Park Seung-Hee
You Ji-Hye
Kim Ji-Hyun
Lim Chul-Hyun
Cho Joo-Young
Kim Gwang-Ha
Lee Yong-Chan
Jung Hwoon-Yong
Kim Ji-Young
Chun Hoon-Jai
Seol Sang-Yong
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Abstract
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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.
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KEYWORD
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Stomach neoplasms, Endoscopy, gastrointestinal, Outcome assess, Prospective studies
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