Is the eCura system useful for selecting patients who require radical surgery after noncurative endoscopic submucosal dissection for early gastric ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-10-05

AUTHORS

Waku Hatta, Takuji Gotoda, Tsuneo Oyama, Noboru Kawata, Akiko Takahashi, Yoshikazu Yoshifuku, Shu Hoteya, Masahiro Nakagawa, Masaaki Hirano, Mitsuru Esaki, Mitsuru Matsuda, Ken Ohnita, Kohei Yamanouchi, Motoyuki Yoshida, Osamu Dohi, Jun Takada, Keiko Tanaka, Shinya Yamada, Tsuyotoshi Tsuji, Hirotaka Ito, Yoshiaki Hayashi, Tomohiro Nakamura, Naoki Nakaya, Tooru Shimosegawa

ABSTRACT

BackgroundWe have established a risk-scoring system, termed the “eCura system,” for the risk stratification of lymph node metastasis in patients who have received noncurative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). We aimed to clarify whether this system contributes to the selection of patients requiring radical surgery after ESD.MethodsBetween 2000 and 2011, 1,969 patients with noncurative ESD for EGC were included in this multicenter study. Depending on the treatment strategy after ESD, we had patients with no additional treatment (n = 905) and those with radical surgery after ESD (n = 1,064). After the application of the eCura system to these patients, cancer recurrence and cancer-specific mortality in each risk category of the system were compared between the two patient groups.ResultsMultivariate Cox analysis revealed that in the high-risk category, cancer recurrence was significantly higher (hazard ratio = 3.13, p = 0.024) and cancer-specific mortality tended to be higher (hazard ratio = 2.66, p = 0.063) in patients with no additional treatment than in those with radical surgery after ESD, whereas no significant differences were observed in the intermediate-risk and low-risk categories. In addition, cancer-specific survival in the low-risk category was high in both patient groups (99.6 and 99.7%). A limitation of this study is that it included a small number of cases with undifferentiated-type EGC (292 cases).ConclusionsThe eCura system is a useful aid for selecting the appropriate treatment strategy after noncurative ESD for EGC. However, caution is needed when applying this system to patients with undifferentiated-type EGC. More... »

PAGES

481-489

References to SciGraph publications

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  • Journal

    TITLE

    Gastric Cancer

    ISSUE

    3

    VOLUME

    21

    Author Affiliations

  • Department of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
  • Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 1-6 Kanda-Surugadai, Chiyoda-ku, 101-8309, Tokyo, Japan
  • Division of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan
  • Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
  • Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, 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 and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, 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
  • Division of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan
  • Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Sendai, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s10120-017-0769-7

    DOI

    http://dx.doi.org/10.1007/s10120-017-0769-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1092087057

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28983696


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