Endoscopic and oncologic outcomes according to indication criteria of endoscopic resection for early gastric cancer: a systematic review and meta-analysis

Park, Se Woo; Lee, Hyuk; Park, Chan Hyuk; Jang, Hyun Joo; Ahn, Hong‐Yup

doi:10.1007/s00464-015-4376-6

Cited by 6 publications

(3 citation statements)

References 40 publications

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“…Therefore, the absolute indication of ESD for EGC is tumors that are confined to the mucosa. Because of the increased desire for minimally invasive treatment that maintains normal gastric function, and because of the technical improvements that have been achieved in endoscopic procedures, an extended indication for endoscopic resection has been proposed [20]. However, because ulcerative EGC is associated with a higher incidence of LNM, ESD has only been used in highly selective cases [21].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the traditionally accepted indication for ESD has been limited to differentiated intramucosal cancer that is less than 20 mm in diameter, without ulceration. However, studies have suggested that selected patients with EGC can also be considered candidates for ESD if they have low risks of LNM [6][7][8]. Thus, the indication for ESD has been expanded [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: Indication for endoscopic treatment based on the risk of lymph node metastasis in patients with ulcerative-type early gastric cancer

Kim¹,

Lee²,

Min³

et al. 2018

Oncotarget

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Background: There is little evidence regarding the appropriate therapeutic modalities for ulcerative-type early gastric cancer (EGC) because the risks and implications of lymph node metastasis (LNM) are unclear. In this study, the indication for endoscopic submucosal dissection (ESD) was investigated in patients with ulcerative-type EGC. Results: The overall LNM rate was 15.1%, 0% for mucosa-confined lesions, and 28.2% for submucosa-infiltrating lesions. In the multivariate analysis, only lymphovascular invasion (P < 0.001) was significantly associated with LNM. Among patients with minute submucosal invasion and no lymphovascular invasion, LNM was only observed in patients with tumor sizes > 2.0 cm. Materials and Methods: We retrospectively analyzed 192 patients with ulcerativetype EGC who underwent radical gastrectomy with D2 lymph node dissection. The LNM risk factors were evaluated using a multivariate logistic regression analysis. Conclusions: Because the LNM risks are negligible, curative ESD could be considered in patients with ulcerative EGC that is confined to the mucosa and histologically differentiated, irrespective of tumor size. Additionally, ESD can be attempted in patients with ulcerative EGC with minute submucosal invasion and a tumor size ≤ 2.0 cm.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Indication for endoscopic treatment based on the risk of lymph node metastasis in patients with ulcerative-type early gastric cancer

Kim¹,

Lee²,

Min³

et al. 2018

Oncotarget

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“…The classic (standard) indication used for determining a patient's eligibility for the procedure. [11] All patients were randomly assigned to the BP solution (BP group) group or the conventional solution group (non-BP group). Randomization was performed using a table (block randomization method according to number of patients assigned to each center) of computer-generated random numbers prepared by a research nurse who was not involved in the ESD procedure.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of submucosal bupivacaine injection for pain relief after endoscopic submucosal dissection

et al. 2019

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Background and aim:Although abdominal pain is a common adverse event related to endoscopic submucosal dissection (ESD), it can be sometimes underestimated by endoscopists. There are some endoscopic interventions available for the prevention of post-ESD pain, but their efficacy has not been established. We investigated whether a submucosal injection of bupivacaine (BP) can reduce procedure-related abdominal pain compared with the standard method.Methods:We performed a multicenter, double-blinded, randomized controlled trial of 86 adult patients referred for ESD as treatment for gastric neoplasms. Patients were randomly assigned to either the BP submucosal or conventional solution group. Questionnaires were collected when the study began (baseline) and immediately after ESD, as well as at 6, 12, and 24 hours post-operatively. The primary outcome was indicated by the visual analog scale (VAS) evaluated at 6 hours after procedure.Results:There were no significant differences in primary outcomes between groups and among all time points (immediately, 12, and 24 hours after ESD). The VAS and short-form McGill pain (SF-MP) scores were higher immediately after ESD than at 6, 12, or 24 hours post-operatively. The incidence of abdominal pain immediately after ESD was 94.0% (78/83) for all patients of both groups, and there was no significant difference between the 2 groups in the rate of abdominal pain immediately after ESD (BP group 37/40 [92.5%] versus non-BP group 41/43 [95.3%], P = .934). In univariable and multivariable analyses, BP did not have protective effect on post-ESD abdominal pain.Conclusions:Submucosal BP injection does not promote pain relief or mitigate the effects of post-ESD abdominal pain.

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Long-term outcomes of endoscopic submucosal dissection in comparison to surgery in undifferentiated-type intramucosal gastric cancer using propensity score analysis

et al. 2017

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Endoscopic and oncologic outcomes according to indication criteria of endoscopic resection for early gastric cancer: a systematic review and meta-analysis

Abstract: This meta-analysis suggests that the EI group showed acceptable long-term outcomes with local recurrence rate that was not significantly inferior, although the metachronous recurrence rate was higher compared with that in the AI group.

Cited by 6 publications

References 40 publications

WITHDRAWN: Indication for endoscopic treatment based on the risk of lymph node metastasis in patients with ulcerative-type early gastric cancer

WITHDRAWN: Indication for endoscopic treatment based on the risk of lymph node metastasis in patients with ulcerative-type early gastric cancer

Efficacy of submucosal bupivacaine injection for pain relief after endoscopic submucosal dissection

Long-term outcomes of endoscopic submucosal dissection in comparison to surgery in undifferentiated-type intramucosal gastric cancer using propensity score analysis

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