A multicenter retrospective study of endoscopic resection for early gastric cancer

被引：102

作者：

Oda I. ^{[1
]}

Saito D. ^{[1
]}

Tada M. ^{[2
]}

Iishi H. ^{[3
]}

Tanabe S. ^{[4
]}

Oyama T. ^{[5
]}

Doi T. ^{[6
]}

Otani Y. ^{[7
]}

Fujisaki J. ^{[8
]}

Ajioka Y. ^{[9
]}

Hamada T. ^{[10
]}

Inoue H. ^{[11
]}

Gotoda T. ^{[1
]}

Yoshida S. ^{[6
]}

机构：

[1] Endoscopy Division, National Cancer Center Hospital, Chuo-ku, Tokyo 104-0045

[2] Division of Gastroenterology, Saitama Cancer Center, Ina, Saitama

[3] Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka

[4] Department of Gastroenterology, Kitasato University, School of Medicine, Sagamihara

[5] Gastroenterology, Saku Central Hospital, Saku, Nagano

[6] Division of Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa

[7] Department of Surgery, School of Medicine, Saitama Medical University, Saitama

[8] Endoscopy Division, Cancer Institute Hospital, Tokyo

[9] Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata

[10] Department of Internal Medicine, Social Health Insurance Medical Center, Tokyo

[11] Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama

来源：

Gastric Cancer | 2006年 / 9卷 / 4期

关键词：

Early gastric cancer; Endoscopic mucosal resection; Endoscopic submucosal dissection; Multicenter study;

D O I：

10.1007/s10120-006-0389-0

中图分类号：

学科分类号：

摘要：

Background. The reported outcomes of endoscopic resection (ER) for early gastric cancer (EGC) remain limited to several single-institution studies. Methods. A multicenter retrospective study was conducted at 11 Japanese institutions concerning their results for ER, including conventional endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). Results. A total of 714 EGCs (EMR, 411; ESD, 303) in 655 consecutive patients were treated from January to December 2001. Technically, 511 of the 714 (71.6%) lesions were resected in one piece. The rate of one-piece resection with ESD (92.7%; 281/303) was significantly higher compared with that for EMR (56.0%; 230/411). Histologically, curative resection was found in 474 (66.3%) lesions. The rate of curative resection with ESD (73.6%; 223/303) was significantly higher compared with that for EMR (61.1%; 251/411). Blood transfusion because of bleeding was required in only 1 patient (0.1%) with EMR of 714 lesions. Perforation was found in 16 (2.2%). The incidence of perforation with ESD (3.6%; 11/303) was significantly higher than that with EMR (1.2%; 5/411). All complications were managed endoscopically, and there was no procedure-related mortality. The median follow-up period was 3.2 years (range, 0.5-5.0 years). In total, the 3-year cumulative residual-free/recurrence-free rate and the 3-year overall survival rate were 94.4% and 99.2%, respectively. The 3-year cumulative residual-free/recurrence-free rate in the ESD group (97.6%) was significantly higher than that in the EMR group (92.5%). Conclusion. ER leads to an excellent 3-year survival in clinical practice and could be a possible standard treatment for EGC. ESD has the advantage of achieving one-piece resection and reducing local residual or recurrent tumor. © 2006 International and Japanese Gastric Cancer Association.

引用

页码：262 / 270

页数：8

共 20 条

[1]

Japanese classification of gastric carcinoma - 2nd English edition, Gastric Cancer, 1, pp. 10-24, (1998)

[2]

Nakamura K., Ueyama T., Yao T., Xuan Z.X., Ambe K., Adachi Y., Et al., Pathology and prognosis of gastric carcinoma. Findings in 10 000 patients who underwent primary gastrectomy, Cancer, 70, pp. 1030-7, (1992)

[3]

Shimizu S., Tada M., Kawai K., Early gastric cancer: Its surveillance and natural course, Endoscopy, 27, pp. 27-31, (1995)

[4]

Rembacken B.J., Gotoda T., Fujii T., Axon T., Endoscopic mucosal resection, Endoscopy, 33, pp. 709-18, (2001)

[5]

Soetikno R.M., Gotoda T., Nakanishi Y., Soehendra N., Endoscopic mucosal resection, Gastrointest Endosc, 57, pp. 567-79, (2003)

[6]

Tada M., Murakami A., Karita M., Yanai H., Okita K., Endoscopic resection of early gastric cancer, Endoscopy, 25, pp. 445-51, (1993)

[7]

Inoue H., Takeshita K., Hori H., Muraoka Y., Yoneshima H., Endo M., Endoscopic mucosal resection with a cap-fitted panendoscope for esophagus, stomach, and colon mucosal lesions, Gastrointest Endosc, 39, pp. 58-62, (1993)

[8]

Tanabe S., Koizumi W., Kokutou M., Imaizumi H., Ishii K., Kida M., Et al., Usefulness of endoscopic aspiration mucosectomy as compared with strip biopsy for the treatment of gastric mucosal cancer, Gastrointest Endosc, 50, pp. 819-22, (1999)

[9]

Suzuki H., Endoscopic mucosal resection using ligating device for early gastric cancer, Gastrointest Endosc Clin N Am, 11, pp. 511-8, (2001)

[10]

Ono H., Kondo H., Gotoda T., Shirao K., Yamaguchi H., Saito D., Et al., Endoscopic mucosal resection for treatment of early gastric cancer, Gut, 48, pp. 225-9, (2001)

← 1 2 →