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Endoscopic Resection for Undifferentiated-Type Early Gastric Cancer: Immediate Endoscopic Outcomes and Long-Term Survivals

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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.

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Author notes

    Authors and Affiliations

    1. Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

      Ji Yong Ahn, Hee Jung 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

    2. Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

      Young Soo Park

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    1. Ji Yong Ahn
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    2. Hee Jung Park
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    Correspondence to Ho June Song.

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    The authors declare no conflict of interest.

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    Ji Yong Ahn and Hee Jung Park have contributed equally to this work as co-first authors.

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    Ahn, J.Y., Park, H.J., Park, Y.S. et al. Endoscopic Resection for Undifferentiated-Type Early Gastric Cancer: Immediate Endoscopic Outcomes and Long-Term Survivals. Dig Dis Sci 61, 1158–1164 (2016). https://doi.org/10.1007/s10620-015-3988-y

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    • DOI: https://doi.org/10.1007/s10620-015-3988-y

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