Comparison between endoscopic submucosal resection and surgery for the curative resection of undifferentiated-type early gastric cancer within expanded indications: a ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-11-19

AUTHORS

Ji Yong Ahn, Young-II Kim, Woon Geon Shin, Hyo-Joon Yang, Su Youn Nam, Byung-Hoon Min, Jae-Young Jang, Joo Hyun Lim, Jie -Hyun Kim, Wan Sik Lee, Bong Eun Lee, Moon Kyung Joo, Jae Myung Park, Hang Lak Lee, Tae- Geun Gweon, Moo In Park, Jeongmin Choi, Chung Hyun Tae, Young-Woo Kim, Boram Park, II Ju Choi

ABSTRACT

Background and aimsEndoscopic submucosal dissection (ESD) for undifferentiated early gastric cancer (UD EGC) has debate due to the risk of lymph node metastasis. We investigated the outcomes of ESD compared to those of surgery for the UD EGC within expanded indication.MethodsWe reviewed 971 UD EGC patients performed ESD across 18 hospitals in Korea and 1812 patients who underwent surgical resection in two hospitals between February 2005 and May 2015. Of these cases, we enrolled a curative resected ESD group of 328 patients and surgery group of 383 cases within an expanded indication. Overall outcomes and one-to-one propensity score-matched (218 ESD group vs 218 surgery group cases) outcomes for these two groups were analyzed.ResultsOver the 75.6 month median follow-up period for the 711 enrolled cases, recurrences occurred in 22 patients (6.7%) in the ESD group but not in the surgery group. Overall survival (OS) was higher in the surgery group (p = 0.0316) in all cases, but there was no significant difference after propensity score matching (p = 0.069). According to the histologic type in propensity score matching, the OS of signet ring cell carcinoma and poorly differentiated carcinoma patients did not differ between the ESD and surgery groups (p = 0.1189 and p = 0.3087, respectively). In the surgery group involving expanded criteria, lymph node metastasis was found in six cases (1.56%).ConclusionsAlthough ESD shows comparable outcomes to surgery for the UD EGC within expanded indications, appropriate patient selection is needed for the ESD due to the possibility of lymph node metastasis. More... »

PAGES

731-743

References to SciGraph publications

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  • Journal

    TITLE

    Gastric Cancer

    ISSUE

    3

    VOLUME

    24

    Author Affiliations

  • Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
  • Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
  • Division of Gastroenterology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, 445, Gil-dong, Kangdong-gu, 05355, Seoul, Korea
  • Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • GastroenterologyKyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
  • Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
  • Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
  • Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
  • Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
  • Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
  • Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
  • Division of Gastroenterology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
  • Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Incheon, Korea
  • Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
  • Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
  • Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
  • Biostatistics Collaboration Team, Research Core Center, Research Institute, National Cancer Center, Goyang, Korea
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s10120-020-01140-x

    DOI

    http://dx.doi.org/10.1007/s10120-020-01140-x

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1132748115

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33211219


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