Clinical Outcome of ESD for Early Gastric Cancer Hisatomo Ikehara 1 , Takuji Gotoda 1 , Kiyoko Makino 1 1Endoscopy Division, National Cancer Center Hospital Keyword: endoscopic submucosal dissection(ESD) , 胃癌治療ガイドライン , 適応拡大 , 病理組織学的評価 , 長期予後 pp.91-98
Published Date 2006/1/25
DOI https://doi.org/10.11477/mf.1403100024
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With the development of new endoscopic resection(ER)techniques such as endoscopic submucosal dissection(ESD), removal of larger early gastric cancer(EGC)lesions has been possible. The benefit of ESD can be achieved only through careful histological examination, so an en-bloc resection is recommended. Among 671 lesions/588 patients were eligible for ER according to the current indication, and were treated by ESD from January, 1999 to August, 2002 at the National Cancer Center Hospital(NCCH). In the histological assessment, the curative resection rate was 78.2%, the non-curative resection rate was 18.2%, and the non-evaluable rate was 3.6%. 481 out of 588 patients were followed up at the NCCH. We assessed the clinical course of these patients according to the curability of ESD. Patients were divided into 4 groups(Curative resection according to the guideline, Curative resection according to the expanded indication, Non-curative resection, and Non-evaluable). No recurrence or metastasis was evident in the curative resection group, except in the long-term follow up of one patient who had local recurrence after piecemeal resection. In the non-curative resection group, after additional surgery, distant metastasis was observed in two patients during the follow-up period. In the non-evaluable group, 21 out of 22 patients were followed up after ESD without additional treatment, and local recurrence and distant LN metastasis were observed in one patient 33.6 months after ESD. High curability was able to be obtained in patients who underwent en-bloc resection in the curative resection group according to the guideline and expanded criteria.

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