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Surgical Endoscopy

, Volume 32, Issue 4, pp 1963–1970 | Cite as

Endoscopic submucosal dissection for undifferentiated-type early gastric cancer: short- and long-term outcomes

  • Hye Kyung Jeon
  • Seong Jun Lee
  • Gwang Ha KimEmail author
  • Do Youn Park
  • Bong Eun Lee
  • Geun Am Song
Article

Abstract

Background and aims

Application of endoscopic submucosal dissection (ESD) for undifferentiated-type early gastric cancers (EGCs) remains controversial owing to limited data regarding long-term outcomes. We aimed to evaluate the feasibility of ESD for undifferentiated-type EGCs that meet the expanded criteria (EC).

Methods

We performed a retrospective analysis of 66 patients who underwent ESD for undifferentiated-type EGC between January 2005 and December 2014. We evaluated the rates of en bloc, complete, and curative resections along with overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS).

Results

Of the 66 patients, the EC group included 38 patients and the beyond-EC group included 28 patients. The overall rates of en bloc, complete, and curative resection of the 66 lesions were 92.4% (61/66), 65.2% (43/66), and 48.5% (32/66), respectively. Of the 34 patients with non-curative resection, 18 underwent additional surgery. Local remnant cancer was detected in 1 patient (1/18, 5.6%), and none of the 18 patients had lymph node metastasis. On multivariate analysis, tumors > 2 cm [odd ratio (OR) 6.183, 95% confidence interval (CI) 1.279–29.880, p = 0.023) and submucosal invasion depth (OR 6.226, 95% CI 1.881–20.606, p = 0.003) were independent predictors of incomplete resection. All 26 patients with more than 1 year of follow-up after curative resection survived without any evidence of local or distant recurrences over a median follow-up period of 36 months. The OS, DSS, and RFS rates of patients with curative ESD were 93.8, 100, and 100%, respectively.

Conclusions

ESD may have favorable long-term outcomes in patients with undifferentiated-type EGC after curative resection.

Keywords

Early gastric cancer Endoscopic submucosal dissection Undifferentiated-type Survival 

Notes

Acknowledgements

This study was supported by a Grant of the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI12C1845).

Compliance with ethical standards

Disclosures

Hye Kyung Jeon, Seong Jun Lee, Gwang Ha Kim, Do Youn Park, Bong Eun Lee, and Geun Am Song have no conflict of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Internal MedicinePusan National University School of Medicine, and Biomedical Research Institute, Pusan National University HospitalBusanRepublic of Korea
  2. 2.Department of Internal MedicineJoeun Gumgang HospitalGimhae-siRepublic of Korea
  3. 3.Department of PathologyPusan National University School of Medicine, and Biomedical Research Institute, Pusan National University HospitalBusanRepublic of Korea

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