Appropriate indications for endoscopic submucosal dissection of early gastric cancer according to tumor size and histologic type - 24/08/11
Reprint requests: Joo Young Cho, MD, Institute for Digestive Research, Digestive Disease Center, SoonChunHyang University Hospital, Seoul, KoreaRésumé |
Background |
Endoscopic submucosal dissection (ESD) is increasingly being performed for early gastric cancers (EGCs) that are larger than 2 cm and those that are not intestinal-type (IT) cancers by Lauren's classification. The technical feasibility of ESD for these EGCs has not been fully evaluated.
Objective |
To identify appropriate expanded indications for ESD of EGC.
Design and Setting |
A retrospective analysis of prospectively collected data was performed on consecutive patients who underwent ESD at a single tertiary center.
Patients and Methods |
In total, 487 EGCs in 461 patients treated by ESD were classified by size and histologic type: IT EGCs 2 cm or less (257 lesions in 235 patients), IT EGCs larger than 2 cm (172 lesions in 168 patients), and non-IT EGCs (58 lesions in 58 patients).
Main Outcome Measurements |
Curative resections were assessed among the 3 groups, and logistic regression analysis was used to analyze factors related to curative resection.
Results |
The rates of curative resection significantly decreased from IT EGCs 2 cm or less (88.7%) to IT EGCs larger than 2 cm (73.3%) to non-IT EGCs (37.9%). Tumor size (>3 cm), ulceration, histologic type (non-IT), and piecemeal resection were independently unfavorable factors in curative resection.
Limitations |
Small sample size and short-term duration of follow-up study.
Conclusions |
ESD with curative intent is technically most feasible for nonulcerative and IT EGCs smaller than 3 cm.
Le texte complet de cet article est disponible en PDF.Abbreviations : APC, DT, EGC, ESD, IT, MT
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
Vol 71 - N° 6
P. 920-926 - mai 2010 Retour au numéro
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