Comparative study between endoscopic submucosal dissection and surgery in patients with early gastric cancer
Authors
Kyu Yeon Hahn ; Chan Hyuk Park ; Yong Kang Lee ; Hyunsoo Chung ; Jun Chul Park ; Sung Kwan Shin ; Yong Chan Lee ; Hyoung-Il Kim ; Jae-Ho Cheong ; Woo Jin Hyung ; Sung Hoon Noh ; Sang Kil Lee
Citation
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.32(1) : 73-86, 2018
BACKGROUND: 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