Predictive Factors for Short-Term Survival after Non-Curative Endoscopic Submucosal Dissection for Early Gastric Cancer

Digestion ◽  
2020 ◽  
pp. 1-10
Author(s):  
Tomohiro Shimada ◽  
Taku Yamagata ◽  
Yoshihide Kanno ◽  
Tetsuya Ohira ◽  
Yoshihiro Harada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Predictive Factors ◽  
Short Term ◽  
Term Survival ◽  
Submucosal Dissection ◽  
Short Term Survival

scholarly journals Impact of Comorbidities, Sarcopenia, and Nutritional Status on the Long-Term Outcomes after Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Patients Aged ≥ 80 Years

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3598
Author(s):  
Ga Hee Kim ◽  
Kee Don Choi ◽  
Yousun Ko ◽  
Taeyong Park ◽  
Kyung Won Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Early Gastric Cancer ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Term Survival ◽  
Factors Associated ◽  
Submucosal Dissection

Background/Aim: We investigated the oncologic outcomes in elderly patients who underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) by focusing on the impact of comorbidities, sarcopenia, and nutritional status. Methods: Between 2005 and 2016, 280 patients aged ≥ 80 years with 289 EGCs underwent ESD at a tertiary care center. The short- and long-term survival outcomes were assessed. Cox regression analysis was used to identify factors associated with survival, including clinicopathologic factors and abdominal muscle area measured by computed tomography. Results: The rates of en bloc, R0, and, curative resection were 99.3%, 90.0%, and 69.2%, respectively. The rates of post-ESD bleeding and perforation rates were 2.1% and 3.1%, respectively, and no cases showed significant life-threatening adverse events. Over a median follow-up period of 70.5 months, the 3- and 5-year overall survival (OS) rates were 89.5% and 77.1%, respectively; of the114 patients who died, only four (3.5%) were due to gastric cancer. A total of 173 (61.8%) had sarcopenia, and they had lower rates of 3-year (88.4% vs. 91.4%) and 5-year (73.1% vs. 84.0%; p = 0.046) OS than did those without sarcopenia. In multivariable analyses, prognostic nutritional index (hazard ratio [HR], 0.93; 95% confidence interval [CI]: 0.90–0.98; p = 0.002) and Charlson comorbidity index (HR 1.19; 95% CI: 1.03–1.37; p = 0.018) were significant factors associated with overall survival. Conclusions: ESD was a feasible and safe therapeutic method to use in elderly patients, whose long-term survival was significantly associated with nutritional status and comorbidities. These results suggest the need for a possible extension of the curative criteria for ESD in elderly patients with EGC.

Predictive Factors of Beyond Expanded Indication of Endoscopic Submucosal Dissection in Early Gastric Cancer

2017 ◽  
Vol 152 (5) ◽  
pp. S258-S259
Author(s):  
Dae Gon Ryu ◽  
Cheol Woong Choi ◽  
Dae Hwan Kang ◽  
Hyung Wook Kim ◽  
Su Bum Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Predictive Factors ◽  
Submucosal Dissection

scholarly journals Predictive factors to diagnosis undifferentiated early gastric cancer after endoscopic submucosal dissection

Medicine ◽  
2017 ◽  
Vol 96 (36) ◽  
pp. e8044 ◽  
Author(s):  
Dae G. Ryu ◽  
Cheol W. Choi ◽  
Dae H. Kang ◽  
Hyung W. Kim ◽  
Su B. Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Predictive Factors ◽  
Submucosal Dissection ◽  
Undifferentiated Early Gastric Cancer

Tu1497 Endoscopic Submucosal Dissection for Gastric Adenomatous Polyps; Predictive Factors for Early Gastric Cancer

2011 ◽  
Vol 73 (4) ◽  
pp. AB427-AB428 ◽  
Author(s):  
Cheol Woong Choi ◽  
Dae Hwan Kang ◽  
Hyung Wook Kim ◽  
Su Bum Park ◽  
Eul Jo Jeong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Predictive Factors ◽  
Adenomatous Polyps ◽  
Submucosal Dissection

scholarly journals Preprocedural prediction of non-curative endoscopic submucosal dissection for early gastric cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 74-74
Author(s):  
Cheol Woong Choi ◽  
Dae Hwan Kang ◽  
Su Jin Kim
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Endoscopic Resection ◽  
Predictive Factors ◽  
Lesion Size ◽  
Treatment Modalities ◽  
Resection Margins ◽  
Tertiary Referral Hospital ◽  
Submucosal Dissection

74 Background: Endoscopic submucosal dissection (ESD) has been accepted as the treatment of choice for early gastric cancer (EGC) without lymph node metastasis. However, additional surgical gastrectomy should be considered after non-curative endoscopic resection. We aimed to evaluate the predictive factors associated with non-curative endoscopic resection. Methods: Between November 2008 and June 2015, a retrospective study was conducted in a single, tertiary, referral hospital. A total of 596 EGC lesions resected by ESD were analyzed. Non-curative endoscopic resection was defined as the occurrence of lesions associated with piecemeal resection, positive resection margins, lymphovascular invasion, or lesions that did not meet the expanded indications for ESD. Results: The rate of non-curative endoscopic resection was 16.1%. The mean follow-up period was 35.3 ± 25.0 months. Associated predictive factors for non-curative endoscopic resection were female sex (OR, 2.470; p = 0.004), lesion size ≥ 20 mm (OR 3.714; p < 0.001), longer procedure time (OR 2.449, p = 0.002), ulceration (OR 3.538, p = 0.002), nodularity (OR 2.967, p < 0.001), depression (OR 1.806, p = 0.038), undifferentiated carcinoma (OR 2.825, p = 0.031) and lesion located in the mid or upper third of stomach (OR 7.135 and OR 4.155, p < 0.001, respectively). As the number of risk factors increased, the risk of non-curative ESD also increased. Conclusions: Prior to selection of ESD, the risks associated with non-curative ESD should be considered so that appropriate treatment modalities may be selected.

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