Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2015

Open Access 01-12-2015 | Research

A comparison of endoscopic submucosal dissection (ESD) and radical surgery for early gastric cancer: a retrospective study

Authors: Wen-chong Song, Xiu-li Qiao, Xiao-zhong Gao

Published in: World Journal of Surgical Oncology | Issue 1/2015

Login to get access

Abstract

Background

Endoscopic submucosal dissection (ESD) has become one of the mainstays of treatment for early gastric cancer (EGC). Radical surgery is also a classical treatment method for EGC. There have been no systematic clinical studies of the curative effects and adverse events associated with ESD vs. radical surgery for EGC. This study investigated the therapeutic efficacy and safety of ESD and radical surgery for EGC.

Methods

Twenty-nine patients with EGC underwent ESD, and 59 underwent radical surgery at Weihai Municipal Hospital. The pathological characteristics, postoperative outcomes, hospital course, morbidity and mortality were retrospectively compared between the two groups.

Results

The oncological clearance was 93.1 % (27/29) in the ESD group. Postoperative delayed haemorrhage occurred in two patients. The hospital stay ranged from 10 to 23 days, and the average stay was 14.3 ± 3.7 days. The patients were followed-up for 1 to 5 years, with a mean follow-up of 26.9 ± 8.5 months. Regular endoscopic examinations showed that the wound had healed with no cancer recurrence in all of the patients. In the radical surgery group, the oncological clearance was 100 % (59/59). The hospital stay ranged from 11 to 55 days, and the average stay was 21.7 ± 9.3 days. The patients were followed-up for 1 to 3.7 years, with a mean follow-up of 22.3 ± 9.4 months. Nine patients developed complications, including acute postoperative adhesive ileus (1/59) and symptomatic residual gastritis (3/59). These complications were improved by an additional operation, drainage, gastrointestinal decompression and comprehensive therapy.

Conclusions

ESD achieved similar efficacy and had many advantages compared with radical surgery for the treatment of EGC.
Literature
1.
Bertuccio P, Chatenoud L, Levi F, Praud D, Ferlay J, Negri E, et al. Recent patterns in gastric cancer: a global overview. Int J Cancer. 2009;125:666–73.CrossRefPubMed
2.
Li LD, Lu FZ, Zhang XW, Mu R, Sun XD, Huangfu XM, et al. Retrospective sampling survey on malignant tumor in China from 1990 to 1992. Chin J Oncol. 1996;8:403–7.
3.
4.
Cheng SD, Chen LN, Wu W, Chen Y, Wu YL. The clinical research of early gastric cancer with benign appearance. Chin J Gastroenterol Hepatol. 2008;17:197–200.
5.
Pugliese R, Maggioni D, Sansonna F, Costanzi A, Ferrari GC, Di Lernia S, et al. Subtotal gastrectomy with D2 dissection by minimally invasive surgery for distal adenocarcinoma of the stomach: results and 5-year survival. Surg Endosc. 2010;24:2594–602.CrossRefPubMed
6.
Jeon TY, Lee S, Kim HH, Kim YJ, Lee JG, Jeong DW, et al. Long-term changes in gut hormones, appetite and food intake 1 year after subtotal gastrectomy with normal body weight. Eur J Clin Nutr. 2010;64:826–31.CrossRefPubMed
7.
Kim MC, Kim KH, Jung GJ, Rattner DW. Comparative study of complete and partial omentectomy in radical subtotal gastrectomy for early gastric cancer. Yonsei Med J. 2011;52:961–6.PubMedCentralCrossRefPubMed
8.
Bo T, Peiwu Y, Feng Q, Yongliang Z, Yan S, Yingxue H, et al. Laparoscopy-assisted vs. open total gastrectomy for advanced gastric cancer: long-term outcomes and technical aspects of a case–control study. J Gastrointest Surg. 2013;17:1202–8.CrossRefPubMed
9.
Grossmann EM, Longo WE, Virgo KS, Johnson FE, Oprian CA, Henderson W, et al. Morbidity and mortality of gastrectomy for cancer in Department of Veterans Affairs Medical Centers. Surgery. 2002;131:484–90.CrossRefPubMed
10.
Tonouchi H, Ohmori Y, Tanaka K, Mohri Y, Kobayashi M, Kusunoki M. Fatal and non-fatal complications after surgery resection for gastric cancer. Hepatogastroenterology. 2006;53:145–9.PubMed
11.
Numata N, Oka S, Tanaka S, Higashiyama M, Sanomura Y, Yoshida S, et al. Clinical outcomes of endoscopic submucosal dissection for early gastric cancer in patients with chronic kidney disease. J Gastroenterol Hepatol. 2013;28:1632–7.PubMed
12.
Oda I, Oyama T, Abe S, Ohnita K, Kosaka T, Hirasawa K, et al. Preliminary results of multicenter questionnaire study on long-term outcomes of curative endoscopic submucosal dissection for early gastric cancer. Dig Endosc. 2014;26:214–9.CrossRefPubMed
13.
Choi MK, Kim GH, Park DY, Song GA, Kim DU, Ryu DY, et al. Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a single-center experience. Surg Endosc. 2013;27:4250–8.CrossRefPubMed
14.
Kato M, Nishida T, Tsutsui S, Komori M, Michida T, Yamamoto K, et al. Endoscopic submucosal dissection as a treatment for gastric noninvasive neoplasia: a multicenter study by Osaka University ESD Study Group. J Gastroenterol. 2011;46:325–31.CrossRefPubMed
15.
Blazeby JM, Conroy T, Bottomley A, Vickery C, Arraras J, Sezer O, et al. Clinical and psychometric validation of a questionnaire module, the EORTC QLQ-STO 22, to assess quality of life in patients with gastric cancer. Eur J Cancer. 2004;40:2260–8.CrossRefPubMed
16.
Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, et al. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): translation and validation study of the Iranian version. Support Care Cancer. 1999;7:400–6.CrossRefPubMed
17.
Huang CC, Lien HH, Sung YC, Liu HT, Chie WC. Quality of life of patients with gastric cancer in Taiwan: validation and clinical application of the Taiwan Chinese version of the EORTC QLQ-C30 and EORTC QLQ-STO22. Psycho-Oncology. 2007;16:945–9.CrossRefPubMed
18.
Grassia M, Petrillo M, Pezzella M, Porfidia R, Reda G, Romano A, et al. Comparison of the 6th and 7th editions of the AJCC/UICC TNM staging system for gastric cancer focusing on the “N” parameter-related survival: the monoinstitutional NodUs Italian study. World J Surg Oncol. 2015;13:215.PubMedCentralCrossRefPubMed
19.
20.
Ichikawa D, Kurioka H, Yamnguchi T, Koike H, Okamoto K, Otsuji E, et al. Postoperative complications following gastrectorny for gastric cancer during the last decade. Hepatogastroenterology. 2004;51:613–7.PubMed
21.
Oh SJ, Choi WB, Song J, Hyung WJ, Choi SH, Noh SH, et al. Complications requiring reoperation after gastrectomy for gastric cancer: 17 years experience in a single institute. J Gastrointest Surg. 2009;13:239–45.CrossRefPubMed
22.
Ikeguchi M, Oka S, Gomyo Y, Tsujitani S, Maeta M, Kaibara N. Postperative morbidity and mortality after gastrectorny for gastric carcinoma. Hepatogastroenterology. 2001;48:1517–20.PubMed
23.
Diaz-de-Liafio A, Yarnoz C, Aguilar R, Artieda C, Ortiz H. Mortality in gastrectomy with D2 lymphadenectomy in a specialised unit. Cir Esp. 2008;83:18–23.CrossRef
24.
Degiuli M, Sasako M, Calgaro M, Garino M, Rebecchi F, Mineccia M, et al. Morbidity and mortality after D1 and D2 gastrectomy for cancer: interim analysis of the Italian Gastric Cancer Study Group (IGCSG) randomised surgical trial. Eur J Surg Oncol. 2004;30:303–8.CrossRefPubMed
25.
Sun XD, Mu R, Zhou YS, Dai XD, Zhang SW, Huangfu XM, et al. Analysis of mortality rate of stomach cancer and its trend in twenty years in China. Chin J Oncol. 2004;26:4–9.
26.
Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N, Japanese Laparoscopic Surgery Study Group. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245:68–72.PubMedCentralCrossRefPubMed
27.
Chiu PW, Teoh AY, To KF, Wong SK, Liu SY, Lam CC, et al. Endoscopic submucosal dissection (ESD) compared with gastrectomy for treatment of early gastric neoplasia: a retrospective cohort study. Surg Endosc. 2012;26:3584–91.CrossRefPubMed
28.
Shimura T, Joh T, Sasaki M, Kataoka H, Tanida S, Ogasawara N, et al. Endoscopic submucosal dissection is useful and safe for intramucosal gastric neoplasms in the elderly. Acta Gastroenterol Belg. 2007;70:323–30.PubMed
29.
Jeon SW, Jung MK, Cho CM, Tak WY, Kweon YO, Kim SK, et al. Predictors of immediate bleeding during endoscopic submucosal dissection in gastric lesions. Surg Endosc. 2009;23:1974–9.CrossRefPubMed
30.
Goto O, Fujishiro M, Oda I, Kakushima N, Yamamoto Y, Tsuji Y, et al. A multicenter survey of the management after gastric endoscopic submucosal dissection related to postoperative bleeding. Dig Dis Sci. 2012;57:435–9.CrossRefPubMed
31.
Fujishiro M, Yahagi N, Kakushima N, Kodashima S, Muraki Y, Ono S, et al. Successful nonsurgical management of perforation complicating endoscopic submucosal dissection of gastrointestinal epithelial neoplasms. Endoscopy. 2006;38:1001–6.CrossRefPubMed
32.
Ono H, Hasuike N, Inui T, Takizawa K, Ikehara H, Yamaguchi Y, et al. Usefulness of a novel electrosurgical knife, the insulation-tipped diathermic knife-2, for endoscopic submucosal dissection of early gastric cancer. Gastric Cancer. 2008;11:47–52.CrossRefPubMed
33.
Ono S, Fujishiro M, Niimi K, Goto O, Kodashima S, Yamamichi N, et al. Long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms. Gastrointest Endosc. 2009;70:860–6.CrossRefPubMed
34.
Na HK, Choi KD, Ahn JY, Lim H, Kim MY, Lee JH, et al. Outcomes of balloon dilation for the treatment of strictures after endoscopic submucosal dissection compared with peptic strictures. Surg Endosc. 2013;27:3237–46.CrossRefPubMed
35.
Cho KB, Jeon WJ, Kim JJ. Worldwide experiences of endoscopic submucosal dissection: not just Eastern acrobatics. World J Gastroenterol. 2011;17:2611–7.PubMedCentralCrossRefPubMed
36.
Abe N, Takeuchi H, Ohki A, Yanagida O, Masaki T, Mori T, et al. Long term outcomes of combination of endoscopic submucosal dissection and laparoscopic lymph node dissection without gastrectomy for early gastric cancer patients who have a potential of lymph node metastasis. Gastrointest Endosc. 2011;74:792–7.CrossRefPubMed
Metadata
Title
A comparison of endoscopic submucosal dissection (ESD) and radical surgery for early gastric cancer: a retrospective study
Authors
Wen-chong Song
Xiu-li Qiao
Xiao-zhong Gao
Publication date
01-12-2015
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2015
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-015-0724-1

Other articles of this Issue 1/2015

World Journal of Surgical Oncology 1/2015 Go to the issue

Case report

ALPPS and simultaneous right hemicolectomy - step one and resection of the primary colon cancer

Research

Neo-adjuvant hormone therapy for non-metastatic prostate cancer: a systematic review and meta-analysis of 5,194 patients

Review

Primary tumors of the patella

Research

Clear cell carcinoma of the ovary: multi-slice computed tomography findings

Case report

Primary malignant lymphoma combined with clinically “silent” pheochromocytoma in the same adrenal gland

Case report

Long-term complete response of advanced hepatocellular carcinoma treated with multidisciplinary therapy including reduced dose of sorafenib: case report and review of the literature