scholarly journals A Recent Argument for the Use of Endoscopic Submucosal Dissection for Early Gastric Cancers

Gut and Liver ◽  
2020 ◽  
Vol 14 (4) ◽  
pp. 412-422 ◽  
Author(s):  
Waku Hatta ◽  
Takuji Gotoda ◽  
Tomoyuki Koike ◽  
Atsushi Masamune
2008 ◽  
Vol 42 (1) ◽  
pp. 42-47 ◽  
Author(s):  
I-Lin Lee ◽  
Cheng-Shyong Wu ◽  
Shui-Yi Tung ◽  
Paul Y. Lin ◽  
Chien-Hung Shen ◽  
...  

Endoscopy ◽  
2006 ◽  
Vol 38 (10) ◽  
pp. 980-986 ◽  
Author(s):  
Y. Onozato ◽  
H. Ishihara ◽  
H. Iizuka ◽  
N. Sohara ◽  
S. Kakizaki ◽  
...  

Endoscopy ◽  
2020 ◽  
Vol 52 (10) ◽  
pp. 833-838
Author(s):  
Hiroko Nakahira ◽  
Takashi Kanesaka ◽  
Noriya Uedo ◽  
Masayasu Ohmori ◽  
Hiroyoshi Iwagami ◽  
...  

Background During endoscopic submucosal dissection (ESD), procedural difficulty and poor visibility of the cutting plane sometimes cause the operator to cut into the lesion from the cutting-plane side, making the vertical margin positive (VM1) or unclear (VMX). In the present study, we evaluated the risk of recurrence of gastric cancer with VM1 /VMX after ESD. Methods In total, 1723 consecutive gastric cancers treated by ESD at Osaka International Cancer Institute from July 2012 to December 2017 were included in this retrospective cohort study. Among them, 231 submucosal or more deeply invasive gastric cancers were excluded because nontechnical factors may contribute to VM1 /VMX in such lesions. To quantify the risk of cutting into cancer from the cutting-plane side during ESD, the proportion of lesions with VM1 /VMX among the pT1a gastric cancers treated by ESD was calculated. The proportion of recurrence among these cases was calculated after exclusion of lesions with positive lymphovascular invasion or a positive horizontal margin in order to eliminate the obvious risk factors for recurrence. Results Among 1492 pT1a gastric cancers treated by ESD, 28 lesions (1.9 %; 95 % confidence interval [CI] 1.3 % – 2.7 %) histologically showed VM1 /VMX. No local recurrence (0.0 %; 95 %CI 0.0 % – 12.2 %) occurred among 23 cases. The median follow-up period was 41 months (range 10 – 84 months). Conclusions No local recurrence was detected in pT1a gastric cancers after VM1 /VMX resection by ESD. Surveillance endoscopy could be adopted for such cases without additional surgery.


2010 ◽  
Vol 22 (4) ◽  
pp. 282-288 ◽  
Author(s):  
Haruhisa Iizuka ◽  
Satoru Kakizaki ◽  
Naondo Sohara ◽  
Yasuhiro Onozato ◽  
Hiroshi Ishihara ◽  
...  

2015 ◽  
Vol 29 (6) ◽  
pp. 321-325 ◽  
Author(s):  
Takafumi Sugimoto ◽  
Yutaka Yamaji ◽  
Kosuke Sakitani ◽  
Yoshihiro Isomura ◽  
Shuntaro Yoshida ◽  
...  

BACKGROUND: Endoscopic submucosal dissection (ESD) of early gastric cancer is a minimally invasive procedure. However, the risk for metachronous cancers after successful cancer treatment remains high and the risk factors for metachronous cancers have not been elucidated.OBJECTIVE: To evaluate the risk factors for metachronous gastric cancers after ESD with a long-term follow-up.METHODS: A total of 155 consecutive patients (119 men, 36 women, mean age 68.9 years) were treated with ESD between September 2000 and September 2009. Biopsy specimens were obtained from the greater curvature of the antrum and middle corpus to evaluate gastric mucosal status, includingHelicobacter pylori, intestinal metaplasia (IM) and neutrophil infiltration (NI) before ESD. Follow-up endoscopy after ESD was scheduled at two and six months, one year and annually thereafter.H pylorieradication was recommended when possible.RESULTS: The median follow-up period was 4.2 years. Metachronous gastric cancers were found in 23 of 155 patients (3.5% per year). No local recurrences were observed. The cumulative incidence of metachronous gastric cancer was significantly high in IM and NI in the corpus (P=0.0093 and P=0.0025, respectively [log-rank test]). The ORs for IM and NI in the corpus were 2.65 and 3.06, respectively, according to the Cox proportional hazards model (P=0.024 and P=0.0091, respectively).CONCLUSIONS: The presence of IM and NI in the corpus was closely related to the development of metachronous gastric cancer after ESD.


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