Short-term outcomes of endoscopic submucosal dissection in patients with early gastric cancer

A prospective multicenter cohort study

Il Ju Choi, Na Rae Lee, Sang Gyun Kim, Wan Sik Lee, Seun Ja Park, Jae J. Kim, Jun Haeng Lee, Jin Won Kwon, Seung Hee Park, Ji Hye You, Ji Hyun Kim, Chul Hyun Lim, Joo Young Cho, Gwang Ha Kim, Yong Chan Lee, Hwoon Yong Jung, Ji Young Kim, Hoon-Jai Chun, Sang Yong Seol

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

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 grouprelated 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-free en 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 followup studies.

Original languageEnglish
Pages (from-to)739-748
Number of pages10
JournalGut and Liver
Volume10
Issue number5
DOIs
Publication statusPublished - 2016 Sep 1

Fingerprint

Multicenter Studies
Stomach Neoplasms
Cohort Studies
Neoplasms
Endoscopic Mucosal Resection
Therapeutics
Retrospective Studies
Lymph Nodes
Hemorrhage
Neoplasm Metastasis
Survival

Keywords

  • Endoscopy
  • Gastrointestinal
  • Outcome assess
  • Prospective studies
  • Stomach neoplasms

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Short-term outcomes of endoscopic submucosal dissection in patients with early gastric cancer : A prospective multicenter cohort study. / Choi, Il Ju; Lee, Na Rae; 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.

In: Gut and Liver, Vol. 10, No. 5, 01.09.2016, p. 739-748.

Research output: Contribution to journalReview article

Choi, IJ, Lee, NR, Kim, SG, Lee, WS, Park, SJ, Kim, JJ, Lee, JH, Kwon, JW, Park, SH, You, JH, Kim, JH, Lim, CH, Cho, JY, Kim, GH, Lee, YC, Jung, HY, Kim, JY, Chun, H-J & Seol, SY 2016, 'Short-term outcomes of endoscopic submucosal dissection in patients with early gastric cancer: A prospective multicenter cohort study', Gut and Liver, vol. 10, no. 5, pp. 739-748. https://doi.org/10.5009/gnl15466
Choi, Il Ju ; Lee, Na Rae ; 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. / Short-term outcomes of endoscopic submucosal dissection in patients with early gastric cancer : A prospective multicenter cohort study. In: Gut and Liver. 2016 ; Vol. 10, No. 5. pp. 739-748.
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abstract = "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 grouprelated 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-free en 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 followup studies.",
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T1 - Short-term outcomes of endoscopic submucosal dissection in patients with early gastric cancer

T2 - A prospective multicenter cohort study

AU - Choi, Il Ju

AU - Lee, Na Rae

AU - Kim, Sang Gyun

AU - Lee, Wan Sik

AU - Park, Seun Ja

AU - Kim, Jae J.

AU - Lee, Jun Haeng

AU - Kwon, Jin Won

AU - Park, Seung Hee

AU - You, Ji Hye

AU - Kim, Ji Hyun

AU - Lim, Chul Hyun

AU - Cho, Joo Young

AU - Kim, Gwang Ha

AU - Lee, Yong Chan

AU - Jung, Hwoon Yong

AU - Kim, Ji Young

AU - Chun, Hoon-Jai

AU - Seol, Sang Yong

PY - 2016/9/1

Y1 - 2016/9/1

N2 - 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 grouprelated 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-free en 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 followup studies.

AB - 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 grouprelated 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-free en 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 followup studies.

KW - Endoscopy

KW - Gastrointestinal

KW - Outcome assess

KW - Prospective studies

KW - Stomach neoplasms

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U2 - 10.5009/gnl15466

DO - 10.5009/gnl15466

M3 - Review article

VL - 10

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JO - Gut and Liver

JF - Gut and Liver

SN - 1976-2283

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