Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer (second edition)

Ono, Hiroyuki; Yao, Kenshi; Fujishiro, Mitsuhiro; Oda, Ichiro; Uedo, Noriya; Nimura, Satoshi; Yahagi, Naohisa; Iishi, Hiroyasu; Oka, Masashi; Ajioka, Yoichi; Fujimoto, Kazuma

doi:10.1111/den.13883

Cited by 300 publications

(272 citation statements)

References 117 publications

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“…However, with the development of endoscopy, more and more studies believe that ESD is safe and effective for treating undifferentiated histological types (21,22). Therefore, the latest Japanese guidelines suggest that undifferentiated EGC (≤2 cm) formed by ulcers can be treated with ESD (14). However, it should be carefully considered when determining whether or not to perform an endoscopic submucosal dissection on people with undifferentiated EGC.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors and Prediction Model for Non-curative Resection of Early Gastric Cancer With Endoscopic Resection and the Evaluation

Zhang

Zhu

et al. 2021

Front. Med.

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Background and Study Aim: EGC, also known as Early Gastric Cancer is known to lack the lymph node metastasis and confined along the mucosa, which is treated through an endoscopic resection procedure that includes ESD (Endoscopic Submucosal dissection) and EMR (Endoscopic Mucosal Resection). However, some cases underwent residual disease, recurrence, or additional gastrectomy because of non-curative resection. The following research aims to delineate the threat factors causing the non-curative resection as well as develop a predictive model.Patient and Methods: Effort was taken to collect all the records about the health history of pathologically diagnosed EGC who experienced endoscopic treatment in the Department of Endoscopy, the Capital Medical University, and Beijing Friendship Hospital from January 2012 to January 2020. Patients were grouped into two categories primarily; a curative resection group and finally a non-curative resection group based on the outcomes of the postoperative pathological and immunohistochemical examination results. The statistical methods used included single factor analysis, a multivariate logistic regression analysis and a chi-square test. A nomogram for the prediction of non-curative resection was constructed, which included information on age, gender, resection method, postoperative pathology, tumor size, ulcer, treatment, and infiltration depth. Receiver operating characteristic (ROC) curve analysis and calibration were performed to present the predictive accuracy of the nomogram.Results: Of 443 patients with 478 lesions who had undergone ESD or EMR for EGCs, 127 were identified as being treated non-curative resection. Older patients (>60 years), a large tumor size (>30 mm), submucosal lesion, piecemeal resection, EMR for treatment and undifferentiated tumor histology were associated with non-curative resection group. Our risk nomogram showed good discriminated performance in internal validation (bootstrap-corrected area under the receiver-operating characteristic curve, 0.881; P < 0.001).Conclusions: A validated prediction model was developed to identify people who were subject to undergoing a non-curative resection for ESD. The predictive model that we formulated is essential in providing reliable information to guide the decision-making process on the treatment for EGC before undertaking an endoscopic resection.

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Section: Discussionmentioning

confidence: 99%

“…When eCuraC lesions are differentiated-type lesionsand fulfill other criteria to be classified into either eCuraA or eCuraB but was either not resected en bloc or had positive HM, they are considered eCuraC-1. All other eCuraC lesions are considered eCuraC-2 (14).…”

Section: Valuation Of Efficacy Of Resectionmentioning

confidence: 99%

Risk Factors and Prediction Model for Non-curative Resection of Early Gastric Cancer With Endoscopic Resection and the Evaluation

Zhang

Zhu

et al. 2021

Front. Med.

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“…Regarding the treatment policy for colorectal lesions, polyps of sizes ≤20 mm are assessed to determine whether they can be resected at once with a snare, and the treatment method is selected (either endoscopic mucosal resection or endoscopic submucosal dissection). 5 Polyp size is important information for endoscopists; however, it is challenging to estimate it accurately during the procedure. Chaptini et al reported that only 48% of polyp size estimates were within 20% of the correct value according to a web-based video survey conducted with the participation of 873 endoscopists.…”

Section: Introductionmentioning

confidence: 99%

Virtual scale function of gastrointestinal endoscopy for accurate polyp size estimation in real-time: a preliminary study

et al. 2021

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Significance: Polyp size is important for selecting the surveillance interval or treatment policy. Nevertheless, it is challenging to accurately estimate the polyp size during endoscopy. An easy and cost-effective function to assist in polyp size estimation is required.Aim: To propose a virtual scale function for endoscopy and evaluate its performance and expected accuracy.Approach: An adaptive virtual scale behavior was demonstrated. The measurement error of the virtual scale along the distance between the tip of the endoscope and the object plane was evaluated using graph paper. The accuracy of polyp size estimation by an expert endoscopist was compared with the accuracy of the biopsy forceps method using phantom images. Results:The measurement errors of the virtual scale were ≤ 0.7 mm when the distance to the graph paper, which faced the tip of the endoscope, varied from 4 to 30 mm. The accuracy with the virtual scale was significantly higher than that obtained with biopsy forceps (5.3 AE 5.5% versus 11.9 AE 9.4%, P < 0.001). Conclusions:The virtual scale function, which operates in real-time without any additional device, can be used to estimate polyp sizes easily and accurately with endoscopy.

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“…It is associated with a lower rate of adverse events, shorter hospital stay, lower cost, and better quality of life [5][6][7] . Thus, ESD is considered a safe and effective alternative to surgical resection and has become a treatment of choice for EGC and premalignant gastric lesions in Asia 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Endoscopic Submucosal Dissection for Superficial Gastric Neoplasia in a Large Cohort in North America

Ngamruengphong

Ferri

Aihara

et al. 2021

Clinical Gastroenterology and Hepatology

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Background & Aims: Endoscopic submucosal dissection (ESD) is a widely accepted treatment option for superficial gastric neoplasia in Asia, but there are few data on outcomes of gastric ESD from North America. We aimed to evaluate the safety and efficacy of gastric ESD in North America. Methods:We analyzed data from 347 patients who underwent gastric ESD at 25 centers, from 2010 through 2019. We collected data on patient demographics, lesion characteristics, procedure details and related adverse events, treatment outcomes, local recurrence, and vital status at the last follow up. For the 277 patients with available follow-up data, the median interval between initial ESD and last clinical or endoscopic evaluation was 364 days. The primary endpoint was the rate of en bloc and R0 resection. Secondary outcomes included curative resection, rates of adverse events and recurrence, and gastric cancer-related death.

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Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer (second edition)

Cited by 300 publications

References 117 publications

Risk Factors and Prediction Model for Non-curative Resection of Early Gastric Cancer With Endoscopic Resection and the Evaluation

Risk Factors and Prediction Model for Non-curative Resection of Early Gastric Cancer With Endoscopic Resection and the Evaluation

Virtual scale function of gastrointestinal endoscopy for accurate polyp size estimation in real-time: a preliminary study

Efficacy of Endoscopic Submucosal Dissection for Superficial Gastric Neoplasia in a Large Cohort in North America

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