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Non-curative endoscopic resection does not always lead to grave outcomes in submucosal invasive early gastric cancer

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Author(s)
Jun Young ChoiSeong Woo JeonKwang Bum ChoKyung Sik ParkEun Soo KimChang Keun ParkYun Jin ChungJoong Goo KwonJin Tae JungEun Young KimKyeong Ok KimByung Ik JangSi Hyung LeeJeong Bae ParkChang Hun Yang
Keimyung Author(s)
Cho, Kwang BumPark, Kyung SikKim, Eun Soo
Department
Dept. of Internal Medicine (내과학)
Journal Title
Surgical Endoscopy
Issued Date
2015
Volume
29
Issue
7
Keyword
Early gastric cancerEndoscopic submucosal dissectionSubmucosal invasive gastric cancer
Abstract
Background Endoscopic submucosal dissection (ESD)
has been widely performed for the treatment of early gastric
cancer (EGC). The aim of this study is to examine the
effectiveness of ESD in submucosal invasive gastric cancers
(SM-GC), with a special focus on patients who
underwent non-curative resection.
Methods Data for 1,246 patients who underwent ESD for
treatment of EGC at six medical centers in Daegu-Gyeongbuk,
Korea, between February 2003 and May 2010
were collected. After retrospective analysis of ESD databases, 118 patients were enrolled and classified into
three groups: (1) EGC with submucosal invasion less than
500 lm (SM1-GC) that met the expanded criteria (EC)
(SM1 EC, n = 42); (2) SM1-GC that did not meet the EC
(SM1 non-EC, n = 38); and (3) EGC with submucosal
invasion greater than 500 lm (SM2-GC, n = 38).
Results The en bloc and complete resection rates did not
differ significantly among the three groups. However, the
curative resection rate was significantly better in the SM1
EC group (69.0 %) compared to that in SM1 non-EC and
SM2-GC groups (0 % in both cases). Out of a total of 118
patients, 89 (75.4 %) underwent non-curative resection,
and cancer recurrence was observed in 9 (9/89, 10.1 %).
We analyzed the survival rate in these non-curative patients
and the overall survival and disease-free survival did not
differ significantly between patients that were treated with
additional surgical resection and those that were simply
followed up after ESD.
Conclusions Non-curative resection in SM-GC does not
always lead to cancer recurrence. Thus, if additional surgery
cannot be performed because of the patient’s unsuitable
condition or refusal, a close follow-up with endoscopy
can be considered as an alternative for carefully selected
patients. Moreover, as the ESD technology continues to
evolve, it might be possible to expand the criteria for
curative ESD in patients with SM-GC.
Keimyung Author(s)(Kor)
조광범
박경식
김은수
Publisher
School of Medicine
Citation
Jun Young Choi et al. (2015). Non-curative endoscopic resection does not always lead to grave outcomes in submucosal invasive early gastric cancer. Surgical Endoscopy, 29(7), 1842–1849. doi: 10.1007/s00464-014-3874-2
Type
Article
ISSN
0930-2794
Source
https://link.springer.com/article/10.1007%2Fs00464-014-3874-2
DOI
10.1007/s00464-014-3874-2
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33006
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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