Gut Liver.
2015 Mar;9(2):181-187. 10.5009/gnl13417.
Clinical Outcomes of the Endoscopic Submucosal Dissection of Early Gastric Cancer Are Comparable between Absolute and New Expanded Criteria
- Affiliations
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- 1Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. sw-jeon@hanmail.net
- 2Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Korea.
- 3Department of Internal Medicine, Fatima Hospital, Daegu, Korea.
- 4Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
- 5Department of Internal Medicine, Yeungnam University School of Medicine, Daegu, Korea.
- 6Department of Internal Medicine, Dongkuk University School of Medicine, Gyeongju, Korea.
- KMID: 2380762
- DOI: http://doi.org/10.5009/gnl13417
Abstract
- BACKGROUND/AIMS
Advances in endoscopic submucosal dissection (ESD) techniques have led to the development of expanded criteria for endoscopic resection of early gastric cancer (EGC). The aim of this study was to evaluate the short- and long-term outcomes for ESD using indication criteria.
METHODS
A total of 1,105 patients underwent ESD for EGC at six medical centers. The patients were classified into the following two groups based on the lesion size, presence of ulceration and pathological review: an absolute criteria group (n=517) and an expanded criteria group (n=588).
RESULTS
The curative resection rates (91.1% vs 91.3%, p=0.896) were similar in the absolute criteria group and the expanded criteria group. The en bloc resection rates (93.4% and 92.3%, respectively; p=0.488) and complete resection rates (98.3% and 97.4%, respectively; p=0.357) did not differ between the groups. The cumulative disease-free survival rates and the overall survival rates were similar between the groups (p=0.778 and p=0.654, respectively). Independent factors for the curative resection of EGC included tumor location (upper vs middle and lower, 2.632 [1.128-6.144] vs 3.497 [1.560-7.842], respectively) and en bloc resection rate 12.576 [7.442-21.250].
CONCLUSIONS
The expanded criteria for ESD in cases of EGC is comparable with the widely accepted pre-existing criteria.
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