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Cited 13 time in webofscience Cited 13 time in scopus
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Risk Factors and Clinical Outcomes of Non-Curative Resection in Patients with Early Gastric Cancer Treated with Endoscopic Submucosal Dissection: A Retrospective Multicenter Study in Korea

Authors
Lee, Si HyungKim, Min CheolJeon, Seong WooLee, Kang NyeongPark, Jong JaeHong, Su Jin
Issue Date
Mar-2020
Publisher
대한소화기내시경학회
Keywords
Early gastric cancer; Endoscopic submucosal dissection; Follow-up; Incomplete resection
Citation
Clinical Endoscopy, v.53, no.2, pp.196 - 205
Indexed
SCOPUS
KCI
Journal Title
Clinical Endoscopy
Volume
53
Number
2
Start Page
196
End Page
205
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54951
DOI
10.5946/ce.2019.123
ISSN
2234-2400
Abstract
Background/Aims: The purpose of this study was to investigate the risk factors and long-term clinical outcomes of non-curative resection (NCR) in a large-scale patient population. Methods: We retrospectively analyzed the clinical data of 3,094 patients who underwent endoscopic submucosal dissection (ESD) of early gastric cancer from March 2005 to March 2018 at 13 institutions in Korea. We analyzed the risk factors for NCR and the survival between patients with curative resection and those with NCR with no additional treatment. Results: The NCR rate was 21.4% (661/3,094). In multivariate regression analysis, the risk factors affecting NCR with ESD were old age, undifferentiated tumor, tumor location in the upper body, tumor size =2 cm, and presence of an ulcer. In Cox proportional hazard regression analysis, tumor size =2 cm, submucosal invasion, positive horizontal margin, and lymphovascular invasion were risk factors for local recurrence. In Kaplan-Meier analysis, there was no statistically significant difference in the overall survival between the two groups (log-rank p=0.788). However, disease-specific survival was significantly lower in the NCR group (log-rank p=0.038). Conclusions: Clinicians should be aware of the risk factors for NCR and local recurrence after ESD for early gastric cancer, and should consider providing additional treatment after NCR.
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Park, Jong Jae
Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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