A multicenter retrospective study of endoscopic resection for early gastric cancer

Oda, Ichiro; Saito, Daizo; Tada, Masahiro; Iishi, Hiroyasu; Tanabe, Satoshi; Oyama, Tsuneo; Doi, Toshihiko; Otani, Yoshihide; Fujisaki, Junko; Ajioka, Yoichi; Hamada, Tsutomu; Inoue, Haruhiro; Gotoda, Takuji; Yoshida, Shigeaki

doi:10.1007/s10120-006-0389-0

Cited by 386 publications

(352 citation statements)

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“…When histological evaluation was difficult, or, revealed that a lesion was outside the indication criteria and/or that it had a positive margin, the curability was defined as noncurative hospital stay (on post-ESD day 10). The complication rate (bleeding and perforation) was similar to those in other reports [2][3][4][5][6][7][8][9][10], showing that ESD was mostly safely performed even in the elderly. Curative ESD was achieved in 366 of 470 lesions (77.9%).…”

Section: Early Outcomessupporting

confidence: 88%

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Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older

et al. 2011

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Background Little information is available on the longterm outcomes of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in patients of advanced age (C80 years). Methods A multicenter study was conducted at 10 Japanese institutions concerning their results for ESD. Data on 440 patients of advanced age (C80 years) with EGC (470 lesions) were collected and reviewed. Early and long-term outcomes of ESD were assessed. We compared the overall survival rates between 3 patient groups, those with curative ESD, additional surgery after noncurative ESD, and nonsurgical follow-up after noncurative ESD.Results Bleeding and perforation rates were 3.2 and 2.8%, respectively. Curative ESD was achieved in 366 of the 470 lesions (77.9%). Of the 104 patients with noncurative ESD, 12 patients (11.5%) underwent additional surgery and 91 patients (87.5%) were followed without surgery. The 5-year survival rate in the patients with nonsurgical follow-up after noncurative ESD (66.7%) was significantly lower than that in the patients with curative ESD (80.3%, p = 0.0001). There was no significant -011-0067-8 difference in the 5-year survival rates between the patients with curative ESD and those with surgery after noncurative ESD (100%, p = 0.21), nor was there a difference in these rates between the patients with surgery after noncurative ESD and those with nonsurgical follow-up after noncurative ESD (p = 0.061). None of the patients developed cancer recurrence after curative ESD, and none developed cancer recurrence following the additional surgery after noncurative ESD. In the patients with curative ESD and in those with surgery after noncurative ESD, the cumulative observed survival was better than the expected survival for the general population of similar age and gender. Conclusions ESD is safe for the treatment of EGC in patients 80 years of age or older. Both curative ESD and additional surgery after noncurative ESD may contribute to the extension of life expectancy.123 Gastric Cancer (2012) 15:70-75 DOI 10.1007/s10120

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Section: Early Outcomessupporting

confidence: 88%

“…Endoscopic submucosal dissection (ESD) is widely recognized as a safe and effective treatment of EGC [2][3][4][5], even in aged or high-risk patients [6][7][8][9][10]. However, little information is available on the long-term outcomes of ESD in a large number of elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older

et al. 2011

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“…Thus, examining the submucosal invasive portion is quite important for predicting lymph node metastasis. In reporting outcomes of ESD for EGCs [10][11][12][13][14][15][16][17], Goto et al [10] noted 5-year overall and disease-specific survival rates of 96.2 and 100%, respectively, with neither lymph node metastasis nor other-organ metastasis. Gotoda et al [11] found no significant difference in overall survival between EGCs that met the guideline criteria and those that met the expanded criteria.…”

Section: Discussionmentioning

confidence: 99%

“…However, the prognosis in patients with SM-GCs treated by ESD remains unspecified, and the actual feasibility of ESD for SM-GCs remains controversial. To our knowledge, although outcomes of EGCs resected by ESD have been reported [10][11][12][13][14][15][16][17], there are no reported comparisons between SM1-GC and SM2-GC. Therefore, we studied outcomes in patients with SM-GCs treated by ESD to determine the feasibility of the procedure across classifications.…”

Section: Introductionmentioning

confidence: 95%

Clinical validity of endoscopic submucosal dissection for submucosal invasive gastric cancer: a single-center study

et al. 2011

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Background The 2010 Japanese Gastric Cancer Association guidelines for the treatment of submucosal invasive gastric cancer (SM-GC) specify size 30 mm or less, differentiated-dominant histology, lack of vessel involvement, and submucosal invasion of less than 500 lm (SM1) as expanded criteria for curative endoscopic resection. Our purpose in this study was to confirm the validity of the expanded indications for curative endoscopic submucosal dissection (ESD) of SM-GC. Methods The study subjects were 173 patients with SM-GC resected by ESD at Hiroshima University Hospital between April 2002 and September 2010, including 99 patients for whom 3-plus years' follow-up information was available. Post-ESD outcomes were compared between cases of SM1-GC that met the expanded ESD criteria, those that did not, and SM2-GC cases.Results Complete resection was achieved for 93.2% of the SM1-GCs that met the expanded criteria. There was neither metastasis to lymph nodes or other organs nor local recurrence among the SM1-GCs. Disease-specific survival did not differ significantly between patients that were simply followed up after ESD and those that were treated by additional surgical resection. Conclusions Our outcome data support the clinical validity of ESD without additional surgical resection for SM1-GCs that meet the expanded criteria.

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“…Recently, many reports showed the superiority of endoscopic submucosal dissection (ESD) compared with endoscopic mucosal resection in terms of higher en bloc and complete resection rate [94][95][96] , and this new technique and the advance of devices allowed to extend the indication of endoscopic resection, which included mucosal cancer without ulcerative findings regardless of tumor size or mucosal cancer with ulcerative findings less than 3 cm, or submucosal invasive cancer (less than 500 μm from the muscularis mucosae) less than 3 cm [97][98][99][100] .…”

Section: Endoscopic Surgery For Gastric Cancermentioning

confidence: 99%

Minimally Invasive Surgery of Gastric Cancer

Güner

Hyung

2017

Minimally Invasive Surgery for Upper Abdominal Cancer

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Minimally invasive surgery for gastric cancer has rapidly gained popularity due to the early detection of early gastric cancer. As advances in instruments and the accumulation of laparoscopic experience increase, laparoscopic techniques are being used for less invasive but highly technical procedures. Recent evidence suggests that the short-and long-term outcomes of minimally invasive surgery for early gastric cancer and advanced gastric cancer are comparable to those of conventional open surgery. However, these results should be confirmed by large-scale multicenter prospective randomized controlled clinical trials.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Gastric cancer; Minimally invasive surgery; Laparoscopic gastrectomyCore tip: Minimally invasive surgery has become an alternative modality for the treatment of gastric cancer.Son SY, Kim HH. Minimally invasive surgery in gastric cancer. World J Gastroenterol 2014; 20(39): 14132-14141 Available from: URL: http://www.wjgnet.com/1007-9327/full/ v20/i39/14132.htm DOI: http://dx.doi.org/10.3748/wjg.v20. tano et al [9] and Nagai et al [10] reported the success of laparoscopy-assisted distal gastrectomy (LADG) for EGC in 1994 and 1995. In the early 2000s, robot-assisted surgery emerged as one of the treatment modalities for EGC, and the first robot-assisted gastrectomy (RAG) for EGC was reported by Hashizume et al [11] in 2003. In 2011, singleincision laparoscopic surgery was described for EGC [12] . MIS has revolutionized the surgical approach to gastric cancer for the past two decades, leading to improvements in patients' quality of life by producing less pain, less blood loss, earlier postoperative recovery, and a shorter hospital stay [13][14][15][16][17][18][19] .Currently, MIS is evolving in two major directions [20] . First, MIS techniques are being used in more radical but less invasive procedures, such as totally laparoscopic distal gastrectomy or laparoscopic total gastrectomy with D1+ or D2 lymphadenectomy. These procedures are comparable to conventional open surgery and can be performed even in patients with advanced gastric cancer (AGC) [21][22][23] . Second, MIS is being employed for function-preserving surgery, including pylorus-preserving gastrectomy (PPG), proximal gastrectomy, and limited gastrectomy with sentinel node navigation surgery. These procedures can assist in improving patients' late postoperative function and quality of life [20,[24][25][26] . RECENT ADVANCES IN LAPAROSCOPIC GASTRECTOMYAs advances in instruments and the accumulation of laparoscopic experience increase, laparoscopic techniques are being used for less invasive but highly technical procedures. Totally laparoscopic gastrectomy (TLG) is one example. TLG has gained popularity since Kanaya et al [27] reported the first delta-shaped anastomosis. A recent meta-analysis (five studies, 652 patients) showed that totally laparoscopic distal gastrectomy has less bleeding, shorter time to first flatus, and lower rates of postoperative complicat...

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A multicenter retrospective study of endoscopic resection for early gastric cancer

Cited by 386 publications

References 20 publications

Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older

Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older

Clinical validity of endoscopic submucosal dissection for submucosal invasive gastric cancer: a single-center study

Minimally Invasive Surgery of Gastric Cancer

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