Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a comparison study to surgery using propensity score-matched analysis

Cho, Jun-Hyung; Cha, Sang-Woo; Kim, Hyun Gun; Lee, Tae Hee; Cho, Joo Young; Ko, Weon Jin; Jin, So-Young; Park, Suyeon

doi:10.1007/s00464-015-4672-1

Cited by 62 publications

(45 citation statements)

References 28 publications

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“…Although the risk of LNM is negligible, controversies exist in terms of the oncologic safety of ESD for EGC meeting the expanded indication criteria; therefore, additional long-term outcome studies should be widely performed to evaluate the safety and benefits of ESD over surgery so as to support the current indication criteria. In our study with a propensityscore-matched analysis, the ESD group had OS and DSS rates similar to those of the surgery group, in accordance with the findings of previous studies [16,[19][20][21][22]. During the follow-up period, recurrences at regional lymph nodes or distant recurrence were not found in the ESD group.…”

Section: Discussionsupporting

confidence: 91%

“…Therefore, it is important to compare the long-term clinical outcomes of ESD and surgery for EGC meeting the expanded indication criteria. Although the long-term outcomes of patients with EGC meeting the expanded indication criteria are reported to be similar after either ESD or surgery [19][20][21][22], there are limited data regarding the optimal treatment strategy for EGC. Therefore, we aimed to evaluate the long-term outcomes of patients who underwent ESD or surgical resection for EGC.…”

Section: Introductionmentioning

confidence: 99%

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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

et al. 2017

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…7,8 Data from retrospective series show comparable oncological outcomes with respect to R0 resection, recurrence and overall survival in patients with EGC treated by ESD or surgery. [17][18][19] However, ESD for EGC is preferable, as patients experienced shorter operative time (90 vs 260 min), lower overall complication rates (5 vs 15%), and hospital stays (3-7 days vs 9-14 days), compared to surgery. 17,19 Furthermore, gastric surgery is expensive and its potential alteration to digestive function can be life-altering for patients.…”

Section: Role Of Esd: Comparing Outcomes For Early Gastrointestinal Tmentioning

confidence: 99%

Endoscopic submucosal dissection in the West: Current status and future directions

Michael

Bourke

2017

Digestive Endoscopy

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Endoscopic submucosal dissection (ESD) was first conceptually described almost 30 years ago in Japan and is now widely practiced throughout East Asia. ESD expands the boundaries of endoscopic resection (ER) by allowing en bloc resection of large early neoplastic lesions within the gastrointestinal tract (GIT). This offers advantages over other ER techniques by facilitating definitive histological staging and curative treatment of early cancer in selected cases. Indeed, the experience of ESD in Eastern countries is significant, and excellent outcomes from high-volume centers are reported. The potential benefits of ESD are recognized by Western endoscopists, but its adoption has been limited. A number of factors contribute to this, including epidemiological differences in GIT neoplasia between Western and Eastern populations and limitations in training opportunities. In this review, we discuss the role of ESD, its current status and the future in Western endoscopic practice.

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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: 91%

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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Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a comparison study to surgery using propensity score-matched analysis

Abstract: The overall survival was similar between the ESD and surgery groups. Compared with surgery, the benefits of ESD included fewer late complications and shorter hospital stay duration.

Cited by 62 publications

References 28 publications

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

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

Endoscopic submucosal dissection in the West: Current status and future directions

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

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