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Early and long‑term outcomes of endoscopic submucosal dissection for early gastric cancer in a large patient series


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Title: Early and long‑term outcomes of endoscopic submucosal dissection for early gastric cancer in a large patient series
Authors: Ohnita, Ken / Isomoto, Hajime / Shikuwa, Saburo / Yajima, Hiroyuki / Minami, Hitomi / Matsushima, Kayoko / Akazawa, Yuko / Yamaguchi, Naoyuki / Fukuda, Eiichiro / Nishiyama, Hitoshi / Takeshima, Fuminao / Nakao, Kazuhiko
Issue Date: Mar-2014
Publisher: Spandidos Publications
Citation: Experimental and Therapeutic Medicine, 7(3), pp.594-598; 2014
Abstract: Endoscopic submucosal dissection (ESD) enables the curative resection of early gastric cancer (EGC); however, little information is available on the long-term outcomes of ESD. This study was conducted to clarify the clinical outcomes of a large number of patients with EGC who underwent ESD. The early outcomes were assessed in 1,209 patients and the long-term outcomes were assessed in 300 patients at a follow-up >5 years after the ESD procedure. The overall survival rates were compared between indication and expanded-indication groups, and between the patients who did or did not undergo additional surgery in an out-of-indication group. Overall survival rates were also compared among different age groups. In total, 617 lesions were classed as the indication group, 507 as the expanded-indication group and 208 as the out-of-indication group. Curative resection rates were 96.6% and 91.5% in the indication and expanded-indication groups, respectively. In terms of the long-term outcomes, 20 of the 146 patients in the indication group, 15 of the 105 patients in the expanded-indication group and one of the 23 patients who underwent additional surgery in the out-of-indication group succumbed due to causes other than gastric cancer. Among the 26 patients who did not undergo additional surgery in the out-of-indication group, 10 mortalities occurred, including one due to gastric cancer. The five-year survival rates were not significantly different between the indication and expanded-indication groups. In the out-of-indication group, the five-year survival rate for the patients who did not undergo additional surgery (65.0%) was significantly lower than that for those who did undergo additional surgery (100%) (P<0.01). The five-year survival rate of patients aged >80 years (67.1%) was significantly lower than that of the younger patients (<60 years, 91.6%; sixties, 93.0%; seventies, 84.5%) (P<0.0001). In conclusion, although expanded-indication of ESD for EGC is appropriate, comorbidities require consideration in elderly patients.
Keywords: Early gastric cancer / Early outcomes / Endoscopic submucosal dissection / Long-term outcomes
URI: http://hdl.handle.net/10069/34202
ISSN: 17920981
DOI: 10.3892/etm.2014.1488
Rights: © Spandidos Publications 2014. All rights reserved.
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/34202

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