Survival Benefit of Additional Surgery After Non-curative Endoscopic Submucosal Dissection for Early Gastric Cancer: A Propensity Score Matching Analysis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-08-09

AUTHORS

Sho Suzuki, Takuji Gotoda, Waku Hatta, 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, Tooru Shimosegawa

ABSTRACT

Background and PurposePrevious studies comparing survival outcomes between patients who did and did not undergo additional surgery after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) were limited in that the baseline characteristics differed significantly between the groups. We aimed to address this limitation and compared survival outcomes between these two groups using propensity score matching analysis.MethodsThe study enrolled 1969 consecutive patients who underwent non-curative ESD for EGC between 2000 and 2011 at any of 19 institutions across Japan. Using propensity score matching analysis, patients who underwent additional surgery (n = 1064) were compared with patients who did not (n = 905). Overall survival (OS) and disease-specific survival (DSS) after ESD were compared between both groups.ResultsPropensity score matching analysis yielded 553 matched pairs and well-balanced baseline characteristics between the two groups. The 5-year OS rates were 91.0% in the additional surgery group and 75.5% in the no additional surgery group, and the 5-year DSS rates were 99.0 and 96.8%, respectively. OS and DSS in the additional surgery group were significantly higher than in the no additional surgery group (OS, p < 0.001; DSS, p = 0.013). In Cox proportional hazard analysis, additional surgery significantly reduced gastric cancer-related death after non-curative ESD for EGC (hazard ratio 0.33, 95% confidence interval 0.12–0.79, p = 0.012).ConclusionsOur findings suggest that additional surgery reduces mortality after non-curative ESD for EGC. We recommend additional surgery for patients after non-curative ESD for EGC. More... »

PAGES

3353-3360

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  • Journal

    TITLE

    Annals of Surgical Oncology

    ISSUE

    11

    VOLUME

    24

    Author Affiliations

  • Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, 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 Internal Medicine, 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, Kashihara, 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
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1245/s10434-017-6039-4

    DOI

    http://dx.doi.org/10.1245/s10434-017-6039-4

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1091133464

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28795364


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