Long-Term Efficacy of Endoscopic Submucosal Dissection Compared with Surgery for Early Gastric Cancer: A Retrospective Cohort Study
1
조회
0
다운로드
6
인용
0
참고문헌
키워드
초록
Background/Aims: This study aimed to compare the outcomesof endoscopic submucosal dissection (ESD) andgastrectomy based on the two sets of indications for ESD,namely guideline criteria (GC) and expanded criteria (EC). Methods: Between January 2004 and July 2007, 213 earlygastric cancer (EGC) patients were enrolled in this study. Of these patients, 142 underwent ESD, and 71 underwentgastrectomy. We evaluated the clinical outcomes of thesepatients according to the criteria. Results: The complicationrates in the ESD and gastrectomy groups were 8.5% and28.2%, respectively. The duration of hospital stay was significantlyshorter in the ESD group than the gastrectomy groupaccording to the GC and EC (p<0.001 and p<0.001, respectively). There was no recurrence in the ESD and gastrectomygroups according to the GC, and the recurrence rates in theESD and gastrectomy groups were 4.7% and 0.0% accordingto the EC, respectively (p=0.279). The occurrence rates ofmetachronous cancer in the ESD and gastrectomy groupswere 5.7% and 5.0% according to the GC (p=1.000) and7.5% and 0.0% according to the EC (p=0.055), respectively. Conclusions: Based on safety, duration of hospital stay, andlong-term outcomes, ESD may be an effective and safe firstlinetreatment for EGC according to the EC and GC.
Abstract
Background/Aims: This study aimed to compare the outcomesof endoscopic submucosal dissection (ESD) andgastrectomy based on the two sets of indications for ESD,namely guideline criteria (GC) and expanded criteria (EC). Methods: Between January 2004 and July 2007, 213 earlygastric cancer (EGC) patients were enrolled in this study. Of these patients, 142 underwent ESD, and 71 underwentgastrectomy. We evaluated the clinical outcomes of thesepatients according to the criteria. Results: The complicationrates in the ESD and gastrectomy groups were 8.5% and28.2%, respectively. The duration of hospital stay was significantlyshorter in the ESD group than the gastrectomy groupaccording to the GC and EC (p<0.001 and p<0.001, respectively). There was no recurrence in the ESD and gastrectomygroups according to the GC, and the recurrence rates in theESD and gastrectomy groups were 4.7% and 0.0% accordingto the EC, respectively (p=0.279). The occurrence rates ofmetachronous cancer in the ESD and gastrectomy groupswere 5.7% and 5.0% according to the GC (p=1.000) and7.5% and 0.0% according to the EC (p=0.055), respectively. Conclusions: Based on safety, duration of hospital stay, andlong-term outcomes, ESD may be an effective and safe firstlinetreatment for EGC according to the EC and GC.
참고문헌 (28)
- Japanese Gastric Cancer Association, "Japanese Classification of Gastric Carcinoma: 2nd English edition", Gastric Cancer, 1, pp.10~24 (1998)
- Everett SM, "Early gastric cancer in Europe", Gut, 41, pp.142~150 (1997)
- Lian J, "A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer", Gastrointest Endosc, 76, pp.763~770 (2012)
- Yamaguchi N, "Clinical outcomes of endoscopic submucosal dissection for early gastric cancer by indication criteria", Digestion, 80, pp.173~181 (2009)
- Gotoda T, "Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers", Gastric Cancer, 3, pp.219~225 (2000)
- Yamao T, "Risk factors for lymph node metastasis from intramucosal gastric carcinoma", Cancer, 77, pp.602~606 (1996)
- Shimada Y, "JGCA (The Japan Gastric Cancer Association). Gastric cancer treatment guidelines", Jpn J Clin Oncol, 34, pp.58~ (2004)
- International Agency for Research on Cancer, "Pathology and genetics of tumours of the digestive system" (2000), IARC Press
- Nagano H, "Indications for gastrectomy after incomplete EMR for early gastric cancer", Gastric Cancer, 8, pp.149~154 (2005)
- Oda I, "Endoscopic submucosal dissection for early gastric cancer: technical feasibility, operation time and complications from large consecutive series", Dig Endosc, 17, pp.54~58 (2005)
- Soetikno RM, "Endoscopic mucosal resection", Gastrointest Endosc, 57, pp.567~579 (2003)
- Gotoda T, "Endoscopic submucosal dissection of early gastric cancer", J Gastroenterol, 41, pp.929~942 (2006)
- Onozato Y, "Endoscopic submucosal dissection for early gastric cancers and large flat adenomas", Endoscopy, 38, pp.980~986 (2006)
- Gotoda T, "A large endoscopic resection by endoscopic submucosal dissection procedure for early gastric cancer", Clin Gastroenterol Hepatol, 3(7 Suppl 1), pp.S71~S73 (2005)
- Imagawa A, "Endoscopic submucosal dissection for early gastric cancer: results and degrees of technical difficulty as well as success", Endoscopy, 38, pp.987~990 (2006)
- Chung IK, "Therapeutic outcomes in 1000 cases of endoscopic submucosal dissection for early gastric neoplasms: Korean ESD Study Group multicenter study", Gastrointest Endosc, 69, pp.1228~1235 (2009)
- Lee H, "A feasibility study on the expanded indication for endoscopic submucosal dissection of early gastric cancer", Surg Endosc, 25, pp.1985~1993 (2011)
- Bonenkamp JJ, "Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients", Lancet, 345, pp.745~748 (1995)
- Sasako M, "Risk factors for surgical treatment in the Dutch Gastric Cancer Trial", Br J Surg, 84, pp.1567~1571 (1997)
- Isomoto H, "Endoscopic submucosal dissection for early gastric cancer: a large-scale feasibility study", Gut, 58, pp.331~336 (2009)
- Nakamoto S, "Indications for the use of endoscopic mucosal resection for early gastric cancer in Japan: a comparative study with endoscopic submucosal dissection", Endoscopy, 41, pp.746~750 (2009)
- Sasako S, "Prognosis of early gastric cancer", Stomach Intest, 28, pp.139~146 (1993)
- Choi KS, "EMR versus gastrectomy for intramucosal gastric cancer: comparison of long-term outcomes", Gastrointest Endosc, 73, pp.942~948 (2011)
- Chiu PW, "Endoscopic submucosal dissection (ESD) compared with gastrectomy for treatment of early gastric neoplasia: a retrospective cohort study", Surg Endosc, 26, pp.3584~3591 (2012)
- Ono H, "Endoscopic mucosal resection for treatment of early gastric cancer", Gut, 48, pp.225~229 (2001)
- Oda I, "A multicenter retrospective study of endoscopic resection for early gastric cancer", Gastric Cancer, 9, pp.262~270 (2006)
- Ahn JY, "Endoscopic and oncologic outcomes after endoscopic resection for early gastric cancer: 1370 cases of absolute and extended indications", Gastrointest Endosc, 74, pp.485~493 (2011)
- Park CH, "Long-term outcome of early gastric cancer after endoscopic submucosal dissection: expanded indication is comparable to absolute indication", Dig Liver Dis, 45, pp.651~656 (2013)