Abstract
Background
Endoscopic submucosal dissection (ESD) is an alternative to surgical resection for treating early gastric cancer (EGC). However, there have been limited reports on the long-term outcome of ESD compared to that of surgical resection. The aim of this study was to evaluate the immediate and long-term clinical and oncologic outcomes of ESD compared to surgical resection.
Method
We retrospectively reviewed data of patients in five centers who were treated with ESD or surgical resection for EGC within expanded criteria for ESD from 2006 to 2008.
Result
ESD group had significantly shorter procedure times, shorter fasting period, and shorter hospital stay than the surgical resection group. Immediate complications in the surgical resection group were more common compared to those in the ESD group. Five-year cancer recurrence rate of the ESD group was 12.3 % and significantly higher than 2.1 % of the surgical resection group (P = 0.001). Five-year disease-free survival rate of the surgical resection group was 97 %, which was significantly higher than 85 % of the ESD group (P = 0.001). Metachronous lesions were equally found every year during the follow-up period in the ESD group. Five-year overall survival rates were 100 % for both groups.
Conclusion
ESD might be an acceptable and effective treatment for EGC considering overall survival rates with fewer early complication rates and shorter duration of hospital stay compared to surgical resection. However, intensive and persistent endoscopic surveillance should be performed after ESD for early detection of metachronous lesions.
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Drs. Seung Jee Ryu, Byung-Wook Kim, Boo Gyeong Kim, Ji Hee Kim, Joon Sung Kim, Jin Il Kim, Jae-Myung Park, Jung-Hwan Oh, Tae Ho Kim, Jin-Jo Kim, Seung-Man Park, Cho Hyun Park, Kyo Young Song, Jun Hyun Lee, Sung Geun Kim, Dong Jin Kim, and Wook Kim have no conflict of interest or financial ties to disclose.
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Ryu, S.J., Kim, BW., Kim, B.G. et al. Endoscopic submucosal dissection versus surgical resection for early gastric cancer: a retrospective multicenter study on immediate and long-term outcome over 5 years. Surg Endosc 30, 5283–5289 (2016). https://doi.org/10.1007/s00464-016-4877-y
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DOI: https://doi.org/10.1007/s00464-016-4877-y