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Long-term outcomes of endoscopic submucosal dissection for undifferentiated type early gastric cancer over 2 cm with R0 resection

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World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 326-334页

作者： Jun Yong Bae Chang Beom Ryu Moon Sung Lee Kulwinder S Dua Internal Medicine and Digestive Disease Center Seoul Medical CenterSeoul 02053South Korea Internal Medicine and Digestive Disease Center and Research Institute Soon Chun Hyang University of School of MedicineBucheon 14584South Korea Department of Medicine Medical College of WisconsinMilwaukeeWI 53226United States

BACKGROUND Endoscopic submucosal dissection(ESD)for over 2 cm in size undifferentiated type(UD type)early gastric cancer(EGC)confined to the mucosa is not only challenging,but also long-term outcomes are not well *** To evaluate the long-term outcomes of ESD done for UD type EGCs confined to the mucosa over 2 cm in size and compare the results with those where the lesions were less than 2 *** 143 patients with UD type EGC confirmed on histology after ESD at a tertiary hospital were *** with synchronous and metachronous lesions and a case with emergency surgery after ESD were excluded.A total of 137 cases were enrolled.79 cases who underwent R0 resection were divided into 2 cm or less(group A)and over 2 cm(group B)in *** Among 79 patients who underwent R0 resection,the number in group A and B were 51 and 28,*** mean follow-up period(SD)was 79.71±45.42 *** was a local recurrence in group A(1/51,2%)and group B(1/28,3.6%)*** patient in group A underwent surgery while the patient in group B underwent repeated ESD with no further recurrences in both *** was no regional lymph node metastasis,distant metastasis,and deaths in both *** R0 resection strategy for ESD on lesions over 2 cm,20.4%(28/137)of patients were able to avoid surgery compared with expanded *** If R0 resection is achieved by ESD,UD type EGCs over 2 cm also showed good and similar clinical outcomes as compared to lesions less than 2 cm when followed for over 5 *** R0 resection strategy,several patients can avoid surgery.

关键词： Undifferentiated type early gastric cancer Endoscopic submucosal dissection Long term outcomes over 2 cm Early gastric cancer

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