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Comparative study between endoscopic submucosal dissection and surgery in patients with early gastric cancer

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dc.contributor.author한규연-
dc.date.accessioned2017-07-11T16:10:23Z-
dc.date.available2017-07-11T16:10:23Z-
dc.date.issued2016-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/149146-
dc.descriptionDept. of Medical Science/석사-
dc.description.abstractINTRODUCTION: Endoscopic submucosal dissection (ESD) is accepted as a standard treatment in patients with early gastric cancer (EGC) who have a negligible risk of lymph node metastasis. The aim of this study was to compare the short-term and long-term outcomes between ESD and surgery in patients with EGC that fulfilled the expanded indication of ESD on their final pathologic report. METHODS: We reviewed the clinical data of patients who underwent gastric ESD and surgery between January 2007 and December 2012. Patients with pathologically confirmed EGC that fulfilled the expanded indication of ESD on their final pathologic report were analyzed. RESULTS: Among 2023 patients, 817 (40.4%) underwent ESD and 1206 (59.6%) underwent surgery. The proportion of cases meeting the absolute indication was significantly higher in the ESD group than in the surgery group (66.0% vs. 26.2%). Lesions on the middle third, >3 cm in size, flat or depressed, and of undifferentiated histology were significantly more common in the surgery group than in the ESD group. The ESD group showed lower acute complication rates (8.1% [66 of 817] vs. 18.1% [218 of 1206], P ≤ 0.001) and procedure-related mortality (0% vs. 0.3% [4 of 1206], P = 0.153) than the surgical group. The annual incidence of recurrent gastric cancer was 2.18% in the ESD group and 0.19% in the surgery group. Two patients in the ESD group and three patients in the surgery group showed distant metastasis after treatment. The 5-year overall and disease-specific survival rates were not significantly different between the ESD group and the surgery group (overall survival: 96.4% vs. 97.2%, P = 0.423; disease-specific survival: 99.6% vs. 99.2%, P = 0.203). CONCLUSIONS: Although EGC lesions had poorer features in the surgery group than in the ESD group, ESD was comparable to surgery for EGCs that fulfilled the expanded indication of ESD, with lower rates of acute complication and comparable overall survival.-
dc.description.statementOfResponsibilityopen-
dc.publisherGraduate School, Yonsei University-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleComparative study between endoscopic submucosal dissection and surgery in patients with early gastric cancer-
dc.title.alternative조기위암의 내시경 점막하 박리술 치료와 수술적 치료의 치료 성적 비교 연구-
dc.typeThesis-
dc.contributor.alternativeNameHahn, Kyu Yeon-
dc.type.localThesis-
Appears in Collections:
6. Others (기타) > Dept. of Health Promotion (건강의학과) > 2. Thesis

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