Published in:
01-04-2016 | Original Article
Endoscopic Resection for Undifferentiated-Type Early Gastric Cancer: Immediate Endoscopic Outcomes and Long-Term Survivals
Authors:
Ji Yong Ahn, Hee Jung Park, Young Soo Park, Jeong Hoon Lee, Kwi-Sook Choi, Kee Wook Jeong, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Published in:
Digestive Diseases and Sciences
|
Issue 4/2016
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Abstract
Background
Endoscopic resection (ER) is considered carefully as a curative treatment option for selected cases of undifferentiated-type early gastric cancer (UEGC). This study investigated immediate endoscopic and long-term survival outcomes of patients with UEGC treated with ER.
Methods
A review of a database of 2483 EGC consecutively enrolled patients who underwent ER between January 2004 and December 2010 identified 101 patients with UEGC who met the expanded indications. Outcomes were investigated in these patients.
Results
The rates of R0 en bloc and curative resection were 86 and 70 %, respectively. Of 30 tumors non-curatively resected, 17 were larger than 20 mm in diameter, 12 had positive resection margins, and 13 had submucosal or lymphovascular invasion on resection pathology. ER-related complications occurred in 12 patients (12 %), with all complications treated endoscopically without surgery. The median ER procedure time was 26 min [interquartile range (IQR) 20–39 min]. Only tumor location in the lower part of the stomach was significantly associated with curative ER (P = 0.038). Tumor recurrence was observed in seven patients at a median 17 months (IQR 12–47 months) after ER. During a median follow-up of 60 months (IQR 48–80 months), the 5-year overall mortality rates were 5 % in the curative and 4 % in the non-curative resection groups (P = 0.927). There were no gastric cancer-related deaths.
Conclusions
ER shows acceptable immediate endoscopic and long-term survival outcomes in selected patients with UEGC.