Factors associated with technical difficulty of endoscopic submucosal dissection for early gastric cancer that met the expanded indication criteria: post hoc analysis of a multi-institutional prospective confirmatory trial (JCOG0607)
Background There are few reports on the technical difficulty of gastric endoscopic submucosal dissection (ESD). The aim of this study was to investigate the factors associated with the technical difficulty of ESD for early gastric cancer (EGC) using the data from the multicenter non-randomized confi...
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| Veröffentlicht in: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2020, Vol.23 (1), p.168-174 |
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| container_title | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association |
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| creator | Yano, Tomonori Hasuike, Noriaki Ono, Hiroyuki Boku, Narikazu Ogawa, Gakuto Kadota, Tomohiro Oda, Ichiro Doyama, Hisashi Hori, Shinichiro Iishi, Hiroyasu Takahashi, Akiko Takizawa, Kohei Muto, Manabu |
| description | Background
There are few reports on the technical difficulty of gastric endoscopic submucosal dissection (ESD). The aim of this study was to investigate the factors associated with the technical difficulty of ESD for early gastric cancer (EGC) using the data from the multicenter non-randomized confirmatory trial of expanded indication criteria of ESD (JCOG0607).
Methods
The major inclusion criteria were as follows: (1) histologically proven intestinal-type adenocarcinoma; (2) cT1aN0M0; (3) lesion without finding of ulcer (UL-negative) with > 2 cm in size, or UL-positive with ≤ 3 cm; (4) age 20–75 years. The difficult case was defined as ESD taking ≥ 120 min, piecemeal resection, and/or developing perforation during procedure.
Results
Between June 2007 and October 2010, 470 patients were enrolled from 29 institutions. Median procedure time was 79 (range 14–462) min, and it was ≥ 120 min in 127 patients. Twelve patients developed perforation during ESD, and the procedure time was ≥ 120 min in 9 of them. Therefore, 130 patients (27.7%) were identified as difficult cases. Multivariable analysis showed that UL-negative with > 5 cm (vs. UL-negative with ≤ 3 cm, odds ratio, 24.993; 95% CI 6.130–101.897,
p
3 cm, upper or middle portion of stomach and age ≤ 60 years were independent factors associated with technical difficulty of ESD for EGC. Trial registered number was UMIN000000737. |
| doi_str_mv | 10.1007/s10120-019-00991-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2261280514</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2261280514</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-482c76d620d275145931cce9aca8cb091d181b927f449493fbb300daff10e6723</originalsourceid><addsrcrecordid>eNp9ks9u1DAQxiMEoqXwAhyQJS7lEPCfbBJzQytaQJV6gXPkTOyuq8QOHqeQR-YtmN1tQeLAySP5933fjGaK4qXgbwXnzTsUXEhecqFLzrUWpXpUnIpK1aVSfPP4oZZanBTPEG85Fxst6qfFiRJKilrx0-LXhYEcEzKDGMGbbAf2w-cdyxZ2wYMZ2eCd87CMeWXRMRuGiBBnDwyXflog4oFBtJB9DMzFxKxJ48puDOZEHJgANrG8M5lNNlNhmf05mzBQmA8DpRyUkHy2yZv3bI6Y2S4CM8GMK3rcJxs2URO-9AGzz8teQslzijjvo-8sgxicT5OhgVZG0fR9_mV7fclr3rx5XjxxZkT74v49K75dfPy6_VReXV9-3n64KqGqVC6rVkJTD7Xkg2w2otpoJQCsNmBa6LkWg2hFr2XjqkpXWrm-V5wPxjnBbd1IdVacH32ps--LxdxNHsGOowk2LthJWQvZcrIm9PU_6G1cEk1FlFKqEi01TpQ8UkCjYrKum5OfTFo7wbv9IXTHQ-joELrDIXSKRK_urWlJdvgjedg8AeoIIH2FG5v-Zv_H9jcZg8Mx</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2333418607</pqid></control><display><type>article</type><title>Factors associated with technical difficulty of endoscopic submucosal dissection for early gastric cancer that met the expanded indication criteria: post hoc analysis of a multi-institutional prospective confirmatory trial (JCOG0607)</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Springer Nature - Complete Springer Journals</source><creator>Yano, Tomonori ; Hasuike, Noriaki ; Ono, Hiroyuki ; Boku, Narikazu ; Ogawa, Gakuto ; Kadota, Tomohiro ; Oda, Ichiro ; Doyama, Hisashi ; Hori, Shinichiro ; Iishi, Hiroyasu ; Takahashi, Akiko ; Takizawa, Kohei ; Muto, Manabu</creator><creatorcontrib>Yano, Tomonori ; Hasuike, Noriaki ; Ono, Hiroyuki ; Boku, Narikazu ; Ogawa, Gakuto ; Kadota, Tomohiro ; Oda, Ichiro ; Doyama, Hisashi ; Hori, Shinichiro ; Iishi, Hiroyasu ; Takahashi, Akiko ; Takizawa, Kohei ; Muto, Manabu</creatorcontrib><description>Background
There are few reports on the technical difficulty of gastric endoscopic submucosal dissection (ESD). The aim of this study was to investigate the factors associated with the technical difficulty of ESD for early gastric cancer (EGC) using the data from the multicenter non-randomized confirmatory trial of expanded indication criteria of ESD (JCOG0607).
Methods
The major inclusion criteria were as follows: (1) histologically proven intestinal-type adenocarcinoma; (2) cT1aN0M0; (3) lesion without finding of ulcer (UL-negative) with > 2 cm in size, or UL-positive with ≤ 3 cm; (4) age 20–75 years. The difficult case was defined as ESD taking ≥ 120 min, piecemeal resection, and/or developing perforation during procedure.
Results
Between June 2007 and October 2010, 470 patients were enrolled from 29 institutions. Median procedure time was 79 (range 14–462) min, and it was ≥ 120 min in 127 patients. Twelve patients developed perforation during ESD, and the procedure time was ≥ 120 min in 9 of them. Therefore, 130 patients (27.7%) were identified as difficult cases. Multivariable analysis showed that UL-negative with > 5 cm (vs. UL-negative with ≤ 3 cm, odds ratio, 24.993; 95% CI 6.130–101.897,
p
< 0.0001) had the largest odds ratio and followed by UL-negative with 3–5 cm upper or middle portion of stomach and age ≤ 60 years were significantly associated with difficulty.
Conclusions
UL-negative lesion with > 3 cm, upper or middle portion of stomach and age ≤ 60 years were independent factors associated with technical difficulty of ESD for EGC. Trial registered number was UMIN000000737.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-019-00991-3</identifier><identifier>PMID: 31321630</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Abdominal Surgery ; Adenocarcinoma ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Age ; Aged ; Cancer Research ; Endoscopic Mucosal Resection - methods ; Endoscopy ; Female ; Gastric cancer ; Gastroenterology ; Humans ; Intestine ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Oncology ; Original Article ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Surgical Oncology</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2020, Vol.23 (1), p.168-174</ispartof><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019</rights><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-482c76d620d275145931cce9aca8cb091d181b927f449493fbb300daff10e6723</citedby><cites>FETCH-LOGICAL-c443t-482c76d620d275145931cce9aca8cb091d181b927f449493fbb300daff10e6723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10120-019-00991-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10120-019-00991-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31321630$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yano, Tomonori</creatorcontrib><creatorcontrib>Hasuike, Noriaki</creatorcontrib><creatorcontrib>Ono, Hiroyuki</creatorcontrib><creatorcontrib>Boku, Narikazu</creatorcontrib><creatorcontrib>Ogawa, Gakuto</creatorcontrib><creatorcontrib>Kadota, Tomohiro</creatorcontrib><creatorcontrib>Oda, Ichiro</creatorcontrib><creatorcontrib>Doyama, Hisashi</creatorcontrib><creatorcontrib>Hori, Shinichiro</creatorcontrib><creatorcontrib>Iishi, Hiroyasu</creatorcontrib><creatorcontrib>Takahashi, Akiko</creatorcontrib><creatorcontrib>Takizawa, Kohei</creatorcontrib><creatorcontrib>Muto, Manabu</creatorcontrib><title>Factors associated with technical difficulty of endoscopic submucosal dissection for early gastric cancer that met the expanded indication criteria: post hoc analysis of a multi-institutional prospective confirmatory trial (JCOG0607)</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><addtitle>Gastric Cancer</addtitle><description>Background
There are few reports on the technical difficulty of gastric endoscopic submucosal dissection (ESD). The aim of this study was to investigate the factors associated with the technical difficulty of ESD for early gastric cancer (EGC) using the data from the multicenter non-randomized confirmatory trial of expanded indication criteria of ESD (JCOG0607).
Methods
The major inclusion criteria were as follows: (1) histologically proven intestinal-type adenocarcinoma; (2) cT1aN0M0; (3) lesion without finding of ulcer (UL-negative) with > 2 cm in size, or UL-positive with ≤ 3 cm; (4) age 20–75 years. The difficult case was defined as ESD taking ≥ 120 min, piecemeal resection, and/or developing perforation during procedure.
Results
Between June 2007 and October 2010, 470 patients were enrolled from 29 institutions. Median procedure time was 79 (range 14–462) min, and it was ≥ 120 min in 127 patients. Twelve patients developed perforation during ESD, and the procedure time was ≥ 120 min in 9 of them. Therefore, 130 patients (27.7%) were identified as difficult cases. Multivariable analysis showed that UL-negative with > 5 cm (vs. UL-negative with ≤ 3 cm, odds ratio, 24.993; 95% CI 6.130–101.897,
p
< 0.0001) had the largest odds ratio and followed by UL-negative with 3–5 cm upper or middle portion of stomach and age ≤ 60 years were significantly associated with difficulty.
Conclusions
UL-negative lesion with > 3 cm, upper or middle portion of stomach and age ≤ 60 years were independent factors associated with technical difficulty of ESD for EGC. Trial registered number was UMIN000000737.</description><subject>Abdominal Surgery</subject><subject>Adenocarcinoma</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Cancer Research</subject><subject>Endoscopic Mucosal Resection - methods</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Intestine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgical Oncology</subject><issn>1436-3291</issn><issn>1436-3305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks9u1DAQxiMEoqXwAhyQJS7lEPCfbBJzQytaQJV6gXPkTOyuq8QOHqeQR-YtmN1tQeLAySP5933fjGaK4qXgbwXnzTsUXEhecqFLzrUWpXpUnIpK1aVSfPP4oZZanBTPEG85Fxst6qfFiRJKilrx0-LXhYEcEzKDGMGbbAf2w-cdyxZ2wYMZ2eCd87CMeWXRMRuGiBBnDwyXflog4oFBtJB9DMzFxKxJ48puDOZEHJgANrG8M5lNNlNhmf05mzBQmA8DpRyUkHy2yZv3bI6Y2S4CM8GMK3rcJxs2URO-9AGzz8teQslzijjvo-8sgxicT5OhgVZG0fR9_mV7fclr3rx5XjxxZkT74v49K75dfPy6_VReXV9-3n64KqGqVC6rVkJTD7Xkg2w2otpoJQCsNmBa6LkWg2hFr2XjqkpXWrm-V5wPxjnBbd1IdVacH32ps--LxdxNHsGOowk2LthJWQvZcrIm9PU_6G1cEk1FlFKqEi01TpQ8UkCjYrKum5OfTFo7wbv9IXTHQ-joELrDIXSKRK_urWlJdvgjedg8AeoIIH2FG5v-Zv_H9jcZg8Mx</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Yano, Tomonori</creator><creator>Hasuike, Noriaki</creator><creator>Ono, Hiroyuki</creator><creator>Boku, Narikazu</creator><creator>Ogawa, Gakuto</creator><creator>Kadota, Tomohiro</creator><creator>Oda, Ichiro</creator><creator>Doyama, Hisashi</creator><creator>Hori, Shinichiro</creator><creator>Iishi, Hiroyasu</creator><creator>Takahashi, Akiko</creator><creator>Takizawa, Kohei</creator><creator>Muto, Manabu</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>2020</creationdate><title>Factors associated with technical difficulty of endoscopic submucosal dissection for early gastric cancer that met the expanded indication criteria: post hoc analysis of a multi-institutional prospective confirmatory trial (JCOG0607)</title><author>Yano, Tomonori ; Hasuike, Noriaki ; Ono, Hiroyuki ; Boku, Narikazu ; Ogawa, Gakuto ; Kadota, Tomohiro ; Oda, Ichiro ; Doyama, Hisashi ; Hori, Shinichiro ; Iishi, Hiroyasu ; Takahashi, Akiko ; Takizawa, Kohei ; Muto, Manabu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-482c76d620d275145931cce9aca8cb091d181b927f449493fbb300daff10e6723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Cancer Research</topic><topic>Endoscopic Mucosal Resection - methods</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Intestine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yano, Tomonori</creatorcontrib><creatorcontrib>Hasuike, Noriaki</creatorcontrib><creatorcontrib>Ono, Hiroyuki</creatorcontrib><creatorcontrib>Boku, Narikazu</creatorcontrib><creatorcontrib>Ogawa, Gakuto</creatorcontrib><creatorcontrib>Kadota, Tomohiro</creatorcontrib><creatorcontrib>Oda, Ichiro</creatorcontrib><creatorcontrib>Doyama, Hisashi</creatorcontrib><creatorcontrib>Hori, Shinichiro</creatorcontrib><creatorcontrib>Iishi, Hiroyasu</creatorcontrib><creatorcontrib>Takahashi, Akiko</creatorcontrib><creatorcontrib>Takizawa, Kohei</creatorcontrib><creatorcontrib>Muto, Manabu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yano, Tomonori</au><au>Hasuike, Noriaki</au><au>Ono, Hiroyuki</au><au>Boku, Narikazu</au><au>Ogawa, Gakuto</au><au>Kadota, Tomohiro</au><au>Oda, Ichiro</au><au>Doyama, Hisashi</au><au>Hori, Shinichiro</au><au>Iishi, Hiroyasu</au><au>Takahashi, Akiko</au><au>Takizawa, Kohei</au><au>Muto, Manabu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with technical difficulty of endoscopic submucosal dissection for early gastric cancer that met the expanded indication criteria: post hoc analysis of a multi-institutional prospective confirmatory trial (JCOG0607)</atitle><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle><stitle>Gastric Cancer</stitle><addtitle>Gastric Cancer</addtitle><date>2020</date><risdate>2020</risdate><volume>23</volume><issue>1</issue><spage>168</spage><epage>174</epage><pages>168-174</pages><issn>1436-3291</issn><eissn>1436-3305</eissn><abstract>Background
There are few reports on the technical difficulty of gastric endoscopic submucosal dissection (ESD). The aim of this study was to investigate the factors associated with the technical difficulty of ESD for early gastric cancer (EGC) using the data from the multicenter non-randomized confirmatory trial of expanded indication criteria of ESD (JCOG0607).
Methods
The major inclusion criteria were as follows: (1) histologically proven intestinal-type adenocarcinoma; (2) cT1aN0M0; (3) lesion without finding of ulcer (UL-negative) with > 2 cm in size, or UL-positive with ≤ 3 cm; (4) age 20–75 years. The difficult case was defined as ESD taking ≥ 120 min, piecemeal resection, and/or developing perforation during procedure.
Results
Between June 2007 and October 2010, 470 patients were enrolled from 29 institutions. Median procedure time was 79 (range 14–462) min, and it was ≥ 120 min in 127 patients. Twelve patients developed perforation during ESD, and the procedure time was ≥ 120 min in 9 of them. Therefore, 130 patients (27.7%) were identified as difficult cases. Multivariable analysis showed that UL-negative with > 5 cm (vs. UL-negative with ≤ 3 cm, odds ratio, 24.993; 95% CI 6.130–101.897,
p
< 0.0001) had the largest odds ratio and followed by UL-negative with 3–5 cm upper or middle portion of stomach and age ≤ 60 years were significantly associated with difficulty.
Conclusions
UL-negative lesion with > 3 cm, upper or middle portion of stomach and age ≤ 60 years were independent factors associated with technical difficulty of ESD for EGC. Trial registered number was UMIN000000737.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>31321630</pmid><doi>10.1007/s10120-019-00991-3</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Adenocarcinoma Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Age Aged Cancer Research Endoscopic Mucosal Resection - methods Endoscopy Female Gastric cancer Gastroenterology Humans Intestine Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Odds Ratio Oncology Original Article Stomach Neoplasms - pathology Stomach Neoplasms - surgery Surgical Oncology |
| title | Factors associated with technical difficulty of endoscopic submucosal dissection for early gastric cancer that met the expanded indication criteria: post hoc analysis of a multi-institutional prospective confirmatory trial (JCOG0607) |
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