Long-term outcome of endoscopic submucosal dissection is comparable to that of surgery for early gastric cancer: a propensity-matched analysis

Jeon, Hye Kyung; Kim, Gwang Ha; Lee, Bong Eun; Park, Do Youn; Song, Geun Am; Kim, Dae Hwan; Jeon, Tae Yong

doi:10.1007/s10120-017-0719-4

Cited by 59 publications

(36 citation statements)

References 33 publications

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“…Therefore, endoscopic detection of gastric cancer at an earlier stage is the single most effective measure for reducing gastric cancer mortality. It also offers an opportunity to treat patients with organ-preserving endoscopic therapy such as endoscopic mucosal resection or endoscopic submucosal dissection (ESD) [6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images

Aoyama²,

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images

Aoyama²,

et al. 2018

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“…In this study, metachronous gastric cancer were detected in 5 (14.3%) of the periodically followed up patients after ESD. The incidence rate of metachronous gastric cancer after endoscopic resection is 4.9-9.1% [2,[15][16][17]., which is higher than that after surgery due to preservation of the entire stomach. Therefore, careful EGD surveillance instead of abdominal CT surveillance is important to detect metachronous cancer at an early stage in patients within expanded criteria.…”

Section: Discussionmentioning

confidence: 92%

Clinical significance of regional lymph node enlargement in patients with EGC within the expanded criteria for ESD

et al. 2020

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AbstractsBackground: Lymph node (LN) metastasis is negligible in early gastric cancer (EGC) within expanded criteria for endoscopic submucosal dissection (ESD). However, regional lymph nodes in abdominal CT scans are sometimes enlarged in patients with EGC within the expanded criteria for endoscopic submucosal dissection (ESD). In this study, we investigated the clinical significance of regional lymph node enlargement on abdominal CT scan in patients with EGC within the expanded criteria for ESD. Methods: From December 2010 to April 2015, among 301 patients with EGC within the ESD expanded criteria, 47 patients with regional lymph node enlargement shown by abdominal CT scan were prospectively enrolled. We performed surgical resection or periodic follow-up with abdominal CT scans and upper endoscopy every 6 months to evaluate whether the enlarged lymph nodes are due to metastasis or a reactive change. Results: The mean age of the 47 patients (38 males, 9 female) was 64.8 years. The enlarged lymph nodes were usually single (26/47, 44.6%) and sized as follows: 11 nodes were ≤ 5 mm, 19 were 6-10 mm, and 17 were ≥ 10 mm. Four of the 47 patients initially underwent surgical resection, and 8 patients underwent surgical resection after ESD. However, there was no lymph node metastasis in surgical specimens. Thirty-five patients received ESD and periodically followed up at a median duration of 56 months (IQR: 44-59 month). The enlarged lymph node disappeared in 12 of 35 patients, decreased in 9 patients and remained the same size in 13 patients, and increased in 1 patient. Conclusion: Regional lymph node enlargement on abdominal CT scan in patients within expanded criteria for ESD of ECG may be not due to metastasis but a reactive change.

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“…Diversos estudios han evaluado los resultados de la DSE en el largo plazo comparándolos con la cirugía resectiva. En general, la DSE ha sido asociada a una mayor tasa de recurrencia, pero con similar sobrevida global y específica por cáncer [19][20] . En nuestra serie no registramos recurrencias durante el seguimiento ni mortalidad por cáncer gástrico.…”

Section: Discussionunclassified

“…Aún hoy la DSE en el tratamiento del CGI en pacientes que cumplen con los criterios expandidos es considerada por la Sociedad Japonesa de Cáncer Gástrico como una alternativa terapéutica "en investigación" 18 ; aunque cada vez hay más publicaciones disponibles que la avalan como una alternativa con resultados oncológicos comparables a la gastrectomía con resección ganglionar 19,20 .…”

Section: Introductionunclassified

Desarrollo de la técnica de disección submucosa endoscópica en cáncer gástrico incipiente. Primeros cincuenta casos de un cirujano.

Martínez

2020

Rev. Cirugia

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Introduccion:El cáncer gástrico es un problema de salud en Chile y su mal pronóstico global se explica por un diagnóstico en etapas avanzadas. El cáncer gástrico incipiente (CGI) se asocia a buen pronóstico oncológico y la disección submucosa endoscópica (DSE) como alternativa de tratamiento ha demostrado ser comparable al estándar quirúrgico.Objetivo: Describir la experiencia y resultados de un cirujano en pacientes con CGI sometidos a DSE.Materiales y Métodos: Estudio retrospectivo que incluyó a los pacientes sometidos a DSE por CGI entre mayo 2015 y marzo 2019. Se tabuló información demográfica, datos perioperatorios y del seguimiento obtenidos del registro institucional. Se utilizó estadística descriptiva. Resultados: Se realizaron 52 DSE por CGI en el período analizado. La resección en bloque se logró en un 96% de los casos. La morbilidad alcanzó el 2%, no se registró mortalidad postoperatoria. 98% de las resecciones en bloque fueron consideradas R0 y un 86% de ellas cumplieron estándares de curación. La mediana de seguimiento es de 19 meses y la sobrevida específica por cáncer gástrico y libre de recurrencia alcanza el 100%. Discusión y conclusiones: La DSE es una técnica con potencial curativo en pacientes con CGI, presentando mejores resultados en términos de morbimortalidad, calidad de vida y es comparable a la cirugía en el pronóstico oncológico. Los resultados presentados son concordantes con la literatura y apoyan la implementación de la técnica para el tratamiento del CGI.

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Long-term outcome of endoscopic submucosal dissection is comparable to that of surgery for early gastric cancer: a propensity-matched analysis

Abstract: ESD and surgery have comparable OS rates in patients with EGC. ESD has benefits, including a lower late complication rate and shorter hospital stay. However, RFS and DFS rates might be lower after ESD than after surgery.

Cited by 59 publications

References 33 publications

Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images

Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images

Clinical significance of regional lymph node enlargement in patients with EGC within the expanded criteria for ESD

Desarrollo de la técnica de disección submucosa endoscópica en cáncer gástrico incipiente. Primeros cincuenta casos de un cirujano.

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