Long-term outcomes after non-curative endoscopic submucosal dissection for early gastric cancer according to hospital volumes in Japan: a multicenter propensity-matched ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-02-25

AUTHORS

Osamu Dohi, Waku Hatta, Takuji Gotoda, Yuji Naito, Tsuneo Oyama, Noboru Kawata, Akiko Takahashi, Shiro Oka, Shu Hoteya, Masahiro Nakagawa, Masaaki Hirano, Mitsuru Esaki, Mitsuru Matsuda, Ken Ohnita, Ryo Shimoda, Motoyuki Yoshida, Jun Takada, Keiko Tanaka, Shinya Yamada, Tsuyotoshi Tsuji, Hirotaka Ito, Hiroyuki Aoyagi, Tooru Shimosegawa

ABSTRACT

BackgroundThere is a lack of data regarding the long-term outcomes of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) without curative resection, and the relationship of these outcomes with hospital volumes remains unclear. This study evaluated long-term outcomes of patients who underwent ESD for EGC without curative resection according to hospital volumes in Japan.MethodsThis multicenter retrospective study evaluated 1,969 patients who did not meet the criteria of the Japanese Gastric Cancer Association for curative resection between January 2000 and August 2011. Hospitals were classified according to the annual number of ESD procedures: low- and medium-volume group (LMVG), high-volume group (HVG), and very high-volume group (VHVG). Clinicopathological features, overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were compared across groups after a generalized propensity score matching analysis.ResultsIn 495 pairs of generalized propensity score-matched patients, the 5-year OS, DSS, and RFS rates were 81.5%, 97.9%, and 97.6% for LMVG; 86.9%, 98.2%, and 97.0% for HVG; and 85.4%, 98.5%, and 97.6% for VHVG, respectively. The 5-year DSS and RFS rates did not significantly differ among the three groups. However, 5-year OS was significantly worse in the LMVG than in the HVG and VHVG (P < 0.001 and P = 0.008, respectively).ConclusionsDSS and RFS in patients with EGC who did not meet the criteria for curative resection did not differ across hospital volumes in Japan. Even in cases in which ESD for EGC involved non-curative resection, the procedure is feasible across Japanese hospitals with different volumes. More... »

PAGES

4078-4088

Journal

TITLE

Surgical Endoscopy

ISSUE

12

VOLUME

33

Author Affiliations

  • Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • Department of Gastroenterology, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, 980-8574, Sendai, Miyagi, Japan
  • Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Division of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan
  • Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
  • Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
  • Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
  • Department of Endoscopy, Hiroshima City Hospital, Hiroshima, Japan
  • Department of Internal Medicine, Niigata Prefectural Central Hospital, Joetsu, Japan
  • Department of Gastroenterology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
  • Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
  • Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan
  • Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan
  • Department of Gastroenterology and Endocrinology and Metabolism, Nara Medical University, Nara, Japan
  • Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
  • Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
  • Department of Gastroenterology and Hepatology, Japanese Red Cross Society Kyoto Daiichi Hospital, Kyoto, Japan
  • Department of Gastroenterology, Akita City Hospital, Akita, Japan
  • Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
  • Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00464-019-06710-4

    DOI

    http://dx.doi.org/10.1007/s00464-019-06710-4

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1112380587

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30805782


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