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KMID : 1188320180120040402
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Gut and Liver
2018 Volume.12 No. 4 p.402 ~ p.410
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Long-Term Clinical Outcomes of Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer: A Prospective Multicenter Cohort Study
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Kim Sang-Gyun
Park Chan-Mi
Lee Na-Rae
Kim Ji-Young
Lyu Da-Hyun
Park Seung-Hee
Choi Il-Ju
Lee Wan-Sik
Park Seun-Ja
Kim Jae-Jun
Kim Ji-Hyun
Lim Chul-Hyun
Cho Joo-Young
Kim Gwang-Ha
Lee Yong-Chan
Jung Hwoon-Yong
Lee Jun-Haeng
Chun Hoon-Jai
Seol Sang-Yong
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Abstract
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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.
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KEYWORD
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Survival, Endoscopic mucosal dissection, Stomach neoplasms
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