The impact of endoscopic submucosal dissection for gastric adenocarcinomas in the United States

Kumar, Shria; Metz, David C.; Chandrasekhara, Vinay; Kaplan, David E.; Goldberg, David S.

doi:10.1016/j.tige.2020.03.009

Cited by 2 publications

(1 citation statement)

References 33 publications

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“…Our study demonstrated that a non-antral tumor location was significantly associated with incomplete histological resection. Thus, herein, consistent with the results of previous studies, 18,19 the lesion location was an important factor that affected curative endoscopic resection.…”

Section: Discussionsupporting

confidence: 92%

Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm

Lee,

et al. 2024

Korean J Helicobacter Up Gastrointest Res

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Objectives: Endoscopic submucosal dissection (ESD) is a widely used approach for the resection of superficial gastric neoplastic lesions. Endoscopic mucosal resection (EMR) is acceptable for lesions <10–15 mm in size. Herein, we compared the clinical outcomes of ESD with those of EMR after circumferential precutting (EMR-P) for gastric adenomas ≤15 mm.Methods: We retrospectively analyzed the data of 213 patients with 228 gastric adenomas ≤15 mm in size who were treated endoscopically at a single tertiary hospital in Korea between November 2018 and October 2022. We evaluated the complete endoscopic resection rate, recurrence rate, procedurer-elated complications, and procedure time according to the procedure used.Results: Among the 228 gastric adenomas, 49 were treated with EMR-P and 179 with ESD. The histological complete resection rate was higher in the ESD group than in the EMR-P group (87% vs. 57%, p<0.001). No significant between-group differences were observed in endoscopic en bloc resection rates (ESD vs. EMR-P, 96% vs. 90%; p=0.081). The procedure time was significantly shorter in the EMR-P group than in the ESD group (28.9±19.7 min vs. 8.8±5.9 min, p<0.001). The local recurrence rate in patients with histologically incomplete resection did not differ between the two groups (ESD vs. EMR-P, 8.7% vs. 9.5%; p=0.924).Conclusions: For gastric adenomas ≤15 mm, EMR-P may be the preferable treatment method considering the en bloc resection rate, procedure time, and local recurrence rate. However, considering the complete resection rate, ESD is recommended as the treatment of choice for high-grade adenomas and early gastric cancer lesions.

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Section: Discussionsupporting

confidence: 92%

Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm

Lee,

et al. 2024

Korean J Helicobacter Up Gastrointest Res

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Treatment outcomes of non‐curative endoscopic submucosal dissection for superficial gastric neoplasia: A retrospective study at a tertiary care center in the United States

Nagao,

Nishimura,

Koseki

et al. 2024

DEN Open

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ObjectivesEndoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer; additional treatment may be recommended for patients in whom resection is not curative per the American Society for Gastrointestinal Endoscopy guidelines. The aim of this study was to assess treatment outcomes of ESD for gastric neoplasia, with a focus on cases of non‐curative resection.MethodsThis was a retrospective study of all individuals undergoing ESD for the treatment of gastric adenocarcinoma or dysplasia in a high‐volume tertiary care center in the United States. Data on patient demographic characteristics, clinical history, lesion characteristics, and procedural and clinical outcomes were collected from the electronic medical record.ResultsAmong 82 cases undergoing ESD for the management of gastric neoplasia, 32 cases resulted in non‐curative resection. 20 of these non‐curative cases did not get additional treatment, among which recurrence occurred in two cases with positive horizontal margins only. These patients did not show lymph node metastasis and underwent further endoscopic or surgical resection. There was no recurrence in 11 cases with undifferentiated carcinomas of ≤2 cm in size.ConclusionsAlthough this study was limited by its retrospective design, small sample size, and follow‐up duration, our findings suggest that a risk‐adapted strategy could be employed for certain patients undergoing non‐curative ESD per American Society for Gastrointestinal Endoscopy guidelines, with close follow‐up instead of routine surgery in select cases with favorable features. Further studies are needed to refine the criteria for additional treatment after non‐curative ESD in Western populations.

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The impact of endoscopic submucosal dissection for gastric adenocarcinomas in the United States

Cited by 2 publications

References 33 publications

Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm

Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm

Treatment outcomes of non‐curative endoscopic submucosal dissection for superficial gastric neoplasia: A retrospective study at a tertiary care center in the United States

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