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Long-term outcome of early gastric cancer after endoscopic submucosal dissection: Expanded indication is comparable to absolute indication

 Chan Hyuk Park  ;  Suji Shin  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee  ;  Hyuk Lee 
 DIGESTIVE AND LIVER DISEASE, Vol.45(8) : 651-656, 2013 
Journal Title
Issue Date
Dissection*/methods ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Gastroscopy*/methods ; Hospitals, University ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local/diagnosis* ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/surgery* ; Patient Selection ; Republic of Korea ; Retrospective Studies ; Stomach Neoplasms/diagnosis* ; Stomach Neoplasms/mortality ; Stomach Neoplasms/surgery* ; Treatment Outcome
Endoscopic submucosal dissection ; Indication ; Recurrence ; Survival
BACKGROUND: Endoscopic submucosal dissection has become widely used for early gastric cancer with an expanded indication, although there is no strong consensus. We aimed to compare the clinical and long-term oncological outcome after endoscopic submucosal dissection according to indication. METHODS: Retrospective review of 1152 patients with 1175 lesions who had undergone endoscopic submucosal dissection for early gastric cancer at tertiary educational hospital in Korea, between March 2005 and November 2011. Of these, 366 and 565 lesions were included in the absolute and expanded indication groups, respectively. RESULTS: En bloc resection rates were not significantly different between the absolute and expanded indication groups. The complete resection rate was higher in the absolute indication group versus the expanded indication group (94.8% vs. 89.9%, respectively; P=0.008). In the expanded indication group, complete resection rate was higher in the differentiated versus undifferentiated tumour subgroups (92.9% vs. 78.4%, respectively; P<0.001). Recurrence rates were 7.7% in the absolute indication group vs. 9.3% in the expanded indication group (P=0.524). Disease-free survival was not significantly different between the two indication groups (P=0.634). CONCLUSIONS: Endoscopic submucosal dissection for early gastric cancer with expanded indication is a feasible approach to disease management. Periodic endoscopic follow-up is necessary to detect cancer recurrence.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Park, Chan Hyuk(박찬혁)
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Hyuk(이혁)
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