Clinical Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer by Indication Criteria
Background and Study Aims: Endoscopic submucosal dissection (ESD) can remove early gastric cancer (EGC) en bloc. We sought to assess the feasibility and efficacy of ESD and the clinical outcomes based on the indication criteria. Patients and Methods: 551 patients with 589 EGC lesions were divided in...
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| Veröffentlicht in: | Digestion 2009-01, Vol.80 (3), p.173-181 |
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| creator | Yamaguchi, Naoyuki Isomoto, Hajime Fukuda, Eiichiro Ikeda, Kohki Nishiyama, Hitoshi Akiyama, Motohisa Ozawa, Eisuke Ohnita, Ken Hayashi, Tomayoshi Nakao, Kazuhiko Kohno, Shigeru Shikuwa, Saburo |
| description | Background and Study Aims: Endoscopic submucosal dissection (ESD) can remove early gastric cancer (EGC) en bloc. We sought to assess the feasibility and efficacy of ESD and the clinical outcomes based on the indication criteria. Patients and Methods: 551 patients with 589 EGC lesions were divided into the guideline criteria group (elevated lesion ≤20 mm in diameter and depressed lesion ≤10 mm without ulceration) and the expanded criteria group (mucosal cancer without ulcer findings irrespective of tumor size; mucosal cancer with ulcer findings ≤3 cm in diameter; and minute submucosal invasive cancer ≤3 cm in size). Results: En bloc, complete and curative resection were achieved in 98.6 and 93.0, 95.1 and 88.5, and 97.1 and 91.1%, for the guideline and expanded criteria lesions, respectively; the differences between the 2 groups were significant for each. The expanded criteria lesions were at significantly higher risk of ESD-associated bleeding and perforation. Overall survival was adequate irrespective of the indications, and the disease-specific survival rates were 100% in both. Conclusion: ESD for EGCs that met the expanded criteria was acceptable, though the resection rates and safety were decreased compared to those for the guideline criteria lesions. |
| doi_str_mv | 10.1159/000215388 |
| format | Article |
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We sought to assess the feasibility and efficacy of ESD and the clinical outcomes based on the indication criteria. Patients and Methods: 551 patients with 589 EGC lesions were divided into the guideline criteria group (elevated lesion ≤20 mm in diameter and depressed lesion ≤10 mm without ulceration) and the expanded criteria group (mucosal cancer without ulcer findings irrespective of tumor size; mucosal cancer with ulcer findings ≤3 cm in diameter; and minute submucosal invasive cancer ≤3 cm in size). Results: En bloc, complete and curative resection were achieved in 98.6 and 93.0, 95.1 and 88.5, and 97.1 and 91.1%, for the guideline and expanded criteria lesions, respectively; the differences between the 2 groups were significant for each. The expanded criteria lesions were at significantly higher risk of ESD-associated bleeding and perforation. Overall survival was adequate irrespective of the indications, and the disease-specific survival rates were 100% in both. Conclusion: ESD for EGCs that met the expanded criteria was acceptable, though the resection rates and safety were decreased compared to those for the guideline criteria lesions.</description><identifier>ISSN: 0012-2823</identifier><identifier>EISSN: 1421-9867</identifier><identifier>DOI: 10.1159/000215388</identifier><identifier>PMID: 19776581</identifier><identifier>CODEN: DIGEBW</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Clinical outcomes ; Early Detection of Cancer ; Endoscopy, Gastrointestinal - adverse effects ; Endoscopy, Gastrointestinal - methods ; Female ; Gastric Mucosa - surgery ; Humans ; Male ; Middle Aged ; Original Paper ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Survival Rate</subject><ispartof>Digestion, 2009-01, Vol.80 (3), p.173-181</ispartof><rights>2009 S. Karger AG, Basel</rights><rights>Copyright 2009 S. Karger AG, Basel.</rights><rights>Copyright (c) 2009 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-d283d2eb0b6c9eda638c71eea3f28461982ae412cda9041aa384845500b7d283</citedby><cites>FETCH-LOGICAL-c398t-d283d2eb0b6c9eda638c71eea3f28461982ae412cda9041aa384845500b7d283</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19776581$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamaguchi, Naoyuki</creatorcontrib><creatorcontrib>Isomoto, Hajime</creatorcontrib><creatorcontrib>Fukuda, Eiichiro</creatorcontrib><creatorcontrib>Ikeda, Kohki</creatorcontrib><creatorcontrib>Nishiyama, Hitoshi</creatorcontrib><creatorcontrib>Akiyama, Motohisa</creatorcontrib><creatorcontrib>Ozawa, Eisuke</creatorcontrib><creatorcontrib>Ohnita, Ken</creatorcontrib><creatorcontrib>Hayashi, Tomayoshi</creatorcontrib><creatorcontrib>Nakao, Kazuhiko</creatorcontrib><creatorcontrib>Kohno, Shigeru</creatorcontrib><creatorcontrib>Shikuwa, Saburo</creatorcontrib><title>Clinical Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer by Indication Criteria</title><title>Digestion</title><addtitle>Digestion</addtitle><description>Background and Study Aims: Endoscopic submucosal dissection (ESD) can remove early gastric cancer (EGC) en bloc. We sought to assess the feasibility and efficacy of ESD and the clinical outcomes based on the indication criteria. Patients and Methods: 551 patients with 589 EGC lesions were divided into the guideline criteria group (elevated lesion ≤20 mm in diameter and depressed lesion ≤10 mm without ulceration) and the expanded criteria group (mucosal cancer without ulcer findings irrespective of tumor size; mucosal cancer with ulcer findings ≤3 cm in diameter; and minute submucosal invasive cancer ≤3 cm in size). Results: En bloc, complete and curative resection were achieved in 98.6 and 93.0, 95.1 and 88.5, and 97.1 and 91.1%, for the guideline and expanded criteria lesions, respectively; the differences between the 2 groups were significant for each. The expanded criteria lesions were at significantly higher risk of ESD-associated bleeding and perforation. Overall survival was adequate irrespective of the indications, and the disease-specific survival rates were 100% in both. Conclusion: ESD for EGCs that met the expanded criteria was acceptable, though the resection rates and safety were decreased compared to those for the guideline criteria lesions.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Clinical outcomes</subject><subject>Early Detection of Cancer</subject><subject>Endoscopy, Gastrointestinal - adverse effects</subject><subject>Endoscopy, Gastrointestinal - methods</subject><subject>Female</subject><subject>Gastric Mucosa - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Survival Rate</subject><issn>0012-2823</issn><issn>1421-9867</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpd0M9LwzAUB_AgipvTg3eR4EU8VPOjP5Kj1KmDwQ7uXtL0VTLbZibtYf-9mSsTPD0efN6Xxxeha0oeKU3kEyGE0YQLcYKmNGY0kiLNTtGUEMoiJhifoAvvN_tVxvwcTajMsjQRdIogb0xntGrwaui1bcFjW-N5V1mv7dZo_DGU7aCtD-LFeA-6N7bDtXV4rlyzw2_K9y64XHUaHC53eNFVIfCX5c704Iy6RGe1ajxcjXOG1q_zdf4eLVdvi_x5GWkuRR9VTPCKQUnKVEuoVMqFziiA4jUTcUqlYApiynSlJImpUlzEIk4SQspsfztD94fYrbPfA_i-aI3X0DSqAzv4IuMxEakkJMi7f3JjB9eF3woqExbCExrQwwFpZ713UBdbZ1rldgUlxb744lh8sLdjYOgLqj85Nh3AzQF8KfcJ7gjG-x-XSoXV</recordid><startdate>20090101</startdate><enddate>20090101</enddate><creator>Yamaguchi, Naoyuki</creator><creator>Isomoto, Hajime</creator><creator>Fukuda, Eiichiro</creator><creator>Ikeda, Kohki</creator><creator>Nishiyama, Hitoshi</creator><creator>Akiyama, Motohisa</creator><creator>Ozawa, Eisuke</creator><creator>Ohnita, Ken</creator><creator>Hayashi, Tomayoshi</creator><creator>Nakao, Kazuhiko</creator><creator>Kohno, Shigeru</creator><creator>Shikuwa, Saburo</creator><general>S. 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mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Clinical outcomes</topic><topic>Early Detection of Cancer</topic><topic>Endoscopy, Gastrointestinal - adverse effects</topic><topic>Endoscopy, Gastrointestinal - methods</topic><topic>Female</topic><topic>Gastric Mucosa - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamaguchi, Naoyuki</creatorcontrib><creatorcontrib>Isomoto, Hajime</creatorcontrib><creatorcontrib>Fukuda, Eiichiro</creatorcontrib><creatorcontrib>Ikeda, Kohki</creatorcontrib><creatorcontrib>Nishiyama, Hitoshi</creatorcontrib><creatorcontrib>Akiyama, Motohisa</creatorcontrib><creatorcontrib>Ozawa, Eisuke</creatorcontrib><creatorcontrib>Ohnita, Ken</creatorcontrib><creatorcontrib>Hayashi, Tomayoshi</creatorcontrib><creatorcontrib>Nakao, Kazuhiko</creatorcontrib><creatorcontrib>Kohno, Shigeru</creatorcontrib><creatorcontrib>Shikuwa, Saburo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Digestion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamaguchi, Naoyuki</au><au>Isomoto, Hajime</au><au>Fukuda, Eiichiro</au><au>Ikeda, Kohki</au><au>Nishiyama, Hitoshi</au><au>Akiyama, Motohisa</au><au>Ozawa, Eisuke</au><au>Ohnita, Ken</au><au>Hayashi, Tomayoshi</au><au>Nakao, Kazuhiko</au><au>Kohno, Shigeru</au><au>Shikuwa, Saburo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer by Indication Criteria</atitle><jtitle>Digestion</jtitle><addtitle>Digestion</addtitle><date>2009-01-01</date><risdate>2009</risdate><volume>80</volume><issue>3</issue><spage>173</spage><epage>181</epage><pages>173-181</pages><issn>0012-2823</issn><eissn>1421-9867</eissn><coden>DIGEBW</coden><abstract>Background and Study Aims: Endoscopic submucosal dissection (ESD) can remove early gastric cancer (EGC) en bloc. We sought to assess the feasibility and efficacy of ESD and the clinical outcomes based on the indication criteria. Patients and Methods: 551 patients with 589 EGC lesions were divided into the guideline criteria group (elevated lesion ≤20 mm in diameter and depressed lesion ≤10 mm without ulceration) and the expanded criteria group (mucosal cancer without ulcer findings irrespective of tumor size; mucosal cancer with ulcer findings ≤3 cm in diameter; and minute submucosal invasive cancer ≤3 cm in size). Results: En bloc, complete and curative resection were achieved in 98.6 and 93.0, 95.1 and 88.5, and 97.1 and 91.1%, for the guideline and expanded criteria lesions, respectively; the differences between the 2 groups were significant for each. The expanded criteria lesions were at significantly higher risk of ESD-associated bleeding and perforation. Overall survival was adequate irrespective of the indications, and the disease-specific survival rates were 100% in both. Conclusion: ESD for EGCs that met the expanded criteria was acceptable, though the resection rates and safety were decreased compared to those for the guideline criteria lesions.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>19776581</pmid><doi>10.1159/000215388</doi><tpages>9</tpages></addata></record> |
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| subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Aged, 80 and over Clinical outcomes Early Detection of Cancer Endoscopy, Gastrointestinal - adverse effects Endoscopy, Gastrointestinal - methods Female Gastric Mucosa - surgery Humans Male Middle Aged Original Paper Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - surgery Survival Rate |
| title | Clinical Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer by Indication Criteria |
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