Long-Term Efficacy of Endoscopic Submucosal Dissection Compared with Surgery for Early Gastric Cancer: A Retrospective Cohort Study

• Published in: Gut and liver Vol. 8; no. 5; pp. 519 - 525
• Main Authors: Kim, Dae Yong, Hong, Su Jin, Cho, Gyu Seok, Jeong, Gui Ae, Kim, Hee Kyung, Han, Jae Pil, Lee, Yun Nah, Ko, Bong Min, Lee, Moon Sung
• Format: Journal Article
• Language: English
• Published: Korea (South) Gut and Liver 01.09.2014; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Adult; Aged; Dissection; Early Detection of Cancer; endoscopic submucosal dissection; Endoscopy, Gastrointestinal; Female; Gastrectomy; Gastric Mucosa - surgery; Humans; indication; Length of Stay; long-term outcome; Male; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Original; Patient Safety; Retrospective Studies; Stomach Neoplasms - surgery; Stomach Neoplasms - therapy; Treatment Outcome; 내과학; Endoscopic submucosal dissection; Long-term outcome; Gastrectomy; Indication
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl13061

This study aimed to compare the outcomes of endoscopic submucosal dissection (ESD) and gastrectomy based on the two sets of indications for ESD, namely guideline criteria (GC) and expanded criteria (EC). Between January 2004 and July 2007, 213 early gastric cancer (EGC) patients were enrolled in this study. Of these patients, 142 underwent ESD, and 71 underwent gastrectomy. We evaluated the clinical outcomes of these patients according to the criteria. The complication rates in the ESD and gastrectomy groups were 8.5% and 28.2%, respectively. The duration of hospital stay was significantly shorter in the ESD group than the gastrectomy group according to the GC and EC (p<0.001 and p<0.001, respectively). There was no recurrence in the ESD and gastrectomy groups according to the GC, and the recurrence rates in the ESD and gastrectomy groups were 4.7% and 0.0% according to the EC, respectively (p=0.279). The occurrence rates of metachronous cancer in the ESD and gastrectomy groups were 5.7% and 5.0% according to the GC (p=1.000) and 7.5% and 0.0% according to the EC (p=0.055), respectively. Based on safety, duration of hospital stay, and long-term outcomes, ESD may be an effective and safe first-line treatment for EGC according to the EC and GC.