Gastric Cancer

, Volume 9, Issue 4, pp 262–270

A multicenter retrospective study of endoscopic resection for early gastric cancer

  • Ichiro Oda
  • Daizo Saito
  • Masahiro Tada
  • Hiroyasu Iishi
  • Satoshi Tanabe
  • Tsuneo Oyama
  • Toshihiko Doi
  • Yoshihide Otani
  • Junko Fujisaki
  • Yoichi Ajioka
  • Tsutomu Hamada
  • Haruhiro Inoue
  • Takuji Gotoda
  • Shigeaki Yoshida
Original article

Abstract

Background

The reported outcomes of endoscopic resection (ER) for early gastric cancer (EGC) remain limited to several single-institution studies.

Methods

A multicenter retrospective study was conducted at 11 Japanese institutions concerning their results for ER, including conventional endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).

Results

A total of 714 EGCs (EMR, 411; ESD, 303) in 655 consecutive patients were treated from January to December 2001. Technically, 511 of the 714 (71.6%) lesions were resected in one piece. The rate of one-piece resection with ESD (92.7%; 281/303) was significantly higher compared with that for EMR (56.0%; 230/411). Histologically, curative resection was found in 474 (66.3%) lesions. The rate of curative resection with ESD (73.6%; 223/303) was significantly higher compared with that for EMR (61.1%; 251/411). Blood transfusion because of bleeding was required in only 1 patient (0.1%) with EMR of 714 lesions. Perforation was found in 16 (2.2%). The incidence of perforation with ESD (3.6%; 11/303) was significantly higher than that with EMR (1.2%; 5/411). All complications were managed endoscopically, and there was no procedure-related mortality. The median follow-up period was 3.2 years (range, 0.5–5.0 years). In total, the 3-year cumulative residual-free/recurrence-free rate and the 3-year overall survival rate were 94.4% and 99.2%, respectively. The 3-year cumulative residual-free/recurrence-free rate in the ESD group (97.6%) was significantly higher than that in the EMR group (92.5%).

Conclusion

ER leads to an excellent 3-year survival in clinical practice and could be a possible standard treatment for EGC. ESD has the advantage of achieving one-piece resection and reducing local residual or recurrent tumor.

Key words

Early gastric cancer Endoscopic mucosal resection Endoscopic submucosal dissection Multicenter study 

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Copyright information

© International and Japanese Gastric Cancer Association 2006

Authors and Affiliations

  • Ichiro Oda
    • 1
  • Daizo Saito
    • 1
  • Masahiro Tada
    • 2
  • Hiroyasu Iishi
    • 3
  • Satoshi Tanabe
    • 4
  • Tsuneo Oyama
    • 5
  • Toshihiko Doi
    • 6
  • Yoshihide Otani
    • 7
  • Junko Fujisaki
    • 8
  • Yoichi Ajioka
    • 9
  • Tsutomu Hamada
    • 10
  • Haruhiro Inoue
    • 11
  • Takuji Gotoda
    • 1
  • Shigeaki Yoshida
    • 6
  1. 1.Endoscopy DivisionNational Cancer Center HospitalTokyoJapan
  2. 2.Division of GastroenterologySaitama Cancer CenterInaJapan
  3. 3.Department of Gastrointestinal OncologyOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  4. 4.Department of GastroenterologyKitasato University School of MedicineSagamiharaJapan
  5. 5.GastroenterologySaku Central HospitalSakuJapan
  6. 6.Division of Endoscopy and Gastrointestinal OncologyNational Cancer Center Hospital EastKashiwaJapan
  7. 7.Department of SurgerySchool of Medicine, Saitama Medical UniversitySaitamaJapan
  8. 8.Endoscopy DivisionCancer Institute HospitalTokyoJapan
  9. 9.Division of Molecular and Diagnostic PathologyGraduate School of Medical and Dental Sciences, Niigata UniversityNiigataJapan
  10. 10.Department of Internal MedicineSocial Health Insurance Medical CenterTokyoJapan
  11. 11.Digestive Disease CenterShowa University Northern Yokohama HospitalYokohamaJapan

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