Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a retrospective comparison with conventional endoscopic resection in a single center

Tanabe, Satoshi; Ishido, Kenji; Higuchi, Katsuhiko; Sasaki, Takeshi; Katada, Chikatoshi; Azuma, Mizutomo; Naruke, Akira; Kim, Myungchul; Koizumi, Wasaburo

doi:10.1007/s10120-013-0241-2

Cited by 118 publications

(77 citation statements)

References 18 publications

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“…However, there are few published reports on the long-term outcomes with median follow-up periods of over 5 years ( [10,11,13] reported favorable long-term outcomes of gastric ESD with median follow-up periods of over 5 years; however, the number of cases included in those studies was fewer than the number included in our study. Oda et al [12] also reported the favorable long-term outcomes of curative gastric ESD over follow-up periods of at least 5 years; however, they reported preliminary results of a multicenter questionnaire survey without collecting individual patient data, meaning that they could not estimate the long-term outcomes using the Kaplan-Meier method.…”

Section: Discussionmentioning

confidence: 58%

“…Recently, ESD has been performed to treat EGCs, including large and ulcerative lesions, and there have been a number of published reports on the short-and long-term outcomes of ESD for EGC [1][2][3][4][5][6][7][8][9][10][11][12][13]. However, there are few published reports on the long-term outcomes with median follow-up periods of over 5 years ( [10,11,13] reported favorable long-term outcomes of gastric ESD with median follow-up periods of over 5 years; however, the number of cases included in those studies was fewer than the number included in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the number of EGC patients undergoing ESD has been increasing in Japan. Although a number of reports have indicated favorable short-and longterm outcomes of ESD for EGC, there are few published data on the long-term outcomes of gastric ESD with a median follow-up period of over 5 years [5][6][7][8][9][10][11][12][13]. Therefore, we attempted to assess the long-term outcomes of ESD for EGC based on the data from our large consecutive patient series.…”

Section: Introductionmentioning

confidence: 99%

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High rate of 5-year survival among patients with early gastric cancer undergoing curative endoscopic submucosal dissection

et al. 2015

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Background Endoscopic submucosal dissection (ESD) has been used to treat patients with early gastric cancers (EGCs), including large and ulcerative lesions. Few published data exist on the long-term outcomes of this treatment with median follow-up periods of over 5 years; we therefore aimed to assess the long-term outcomes of EGC patients undergoing ESD. Methods A total of 1,956 consecutive patients with 2,210 EGC lesions at initial onset underwent ESD with curative intent at our hospital from 1999 to 2006. We performed a retrospective analysis of the 5-year survival of EGC patients undergoing curative ESD for absolute indications or for expanded indications. Results For the pathological curability, curative ESD for absolute indications, curative ESD for expanded indications of differentiated-type EGC, and curative ESD for undifferentiated-type EGC were achieved in 781, 713, and 43 patients, respectively. The median follow-up period was 83.3 months. Among the 1,537 patients, there were only two patients with recurrence, including one who developed a regional lymph node (LN) metastasis and one who developed a distant LN metastasis with local recurrence resulting in gastric cancer-related death. Seven died from metachronous gastric cancers. The 5-year rates of overall survival, disease-specific survival, and relative survival were 92.6, 99.9, and 105.0 %, respectively.Conclusions Based on the high rate of 5-year survival among EGC patients undergoing curative ESD for absolute indications or for expanded indications in the largest patient series with a median follow-up period of over 5 years, ESD could be employed as a standard treatment for EGC lesions.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High rate of 5-year survival among patients with early gastric cancer undergoing curative endoscopic submucosal dissection

et al. 2015

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“…3) stated that endoscopic resection for these tumors was regarded as an investigational treatment and ESD should be employed [3]. Excellent long-term outcomes of ESD for EGC that fulfilled the foregoing criteria were reported [5][6][7][8][9][10][11][12]. Although these were retrospective studies, the expanded pathological criteria have been considered acceptable.…”

Section: Case Reportmentioning

confidence: 99%

A case of local recurrence and distant metastasis following curative endoscopic submucosal dissection of early gastric cancer

et al. 2014

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Currently in Japan, differentiated-type gastric submucosal invasive cancers \500 lm with negative lymphovascular involvement are included in expanded pathological criteria for curative endoscopic treatment. This categorization is based on a retrospective examination of surgical resection cases in which patients suitable for such expanded criteria were determined to have a negligible risk of lymph node metastasis. We performed endoscopic submucosal dissection on a 66-year-old man with early gastric cancer in June 2004, and pathology revealed a well-differentiated adenocarcinoma, 16 9 8 mm in size, minute submucosal invasion depth (100 lm), and negative lymphovascular invasion or ulceration as well as tumorfree margins, so the case was diagnosed as a curative resection. In this case, however, local recurrence and distant metastasis resulted in August 2011. The patient received systemic chemotherapy but died of gastric cancer 23 months after recurrence.

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“…Since the early twenty-first century, clinical staging assessments have been considered important becasue of the increased diversity of treatment modalities such as endoscopic submucosal dissection [5], limited surgery for early cancer, and multimodality treatments, including neoadjuvant chemotherapy, for advanced cancer [6,7].…”

Section: Introductionmentioning

confidence: 99%

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

et al. 2016

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Background Preoperative clinical staging of gastric cancer is used to determine therapeutic strategies. However, the impact of the clinical stage on survival has not been completely investigated, although the relationship between pathologic staging and survival outcome has been reported. The aim of the present study was to clarify the predictability of patient survival based on clinical staging and to evaluate the usefulness of staging as an indicator for selecting the treatment modality. Methods A total of 3033 patients who underwent surgery for gastric cancer were included. A survival analysis was conducted based on the seventh edition of the tumor-nodemetastasis (TNM) clinical staging system of the American Joint Committee on Cancer. The predictive ability of the TNM clinical stage for survival was evaluated by Harrell's C-index, a measure of the separation of survival distributions.Results The cumulative 5-year survival rates according to the clinical stage were 94.3 % (IA), 84.7 % (IB), 71.7 % (IIA), 56.1 % (IIB), 55.7 % (IIIA), 42.3 % (IIIB), 22.8 % (IIIC), and 9.1 % (IV). Although no significant difference was observed between clinical stages IIB and IIIA (p = 0.865), significant differences existed between all other clinical stages (p \ 0.001). Harrell's C-index applied to these results was 0.825 (95 % confidence interval 0.819-0.831). Conclusions The seventh edition of the TNM clinical staging system has a strong prognostic ability with a satisfactory C-index and should be considered valuable for selecting therapeutic strategies for the treatment of gastric cancer.

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Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a retrospective comparison with conventional endoscopic resection in a single center

Cited by 118 publications

References 18 publications

High rate of 5-year survival among patients with early gastric cancer undergoing curative endoscopic submucosal dissection

High rate of 5-year survival among patients with early gastric cancer undergoing curative endoscopic submucosal dissection

A case of local recurrence and distant metastasis following curative endoscopic submucosal dissection of early gastric cancer

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

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