Long-term Outcomes of Diagnosed Curability B and Curability C after Endoscopic Submucosal Dissection Kazuo Shiotsuki 1 , Kohei Takizawa 1 , Noboru Kawata 1 , Masao Yoshida 1 , Yohei Yabuuchi 1 , Yoichi Yamamoto 1 , Yoshihiro Kishida 1 , Kenichiro Imai 1 , Kinichi Hotta 1 , Hirotoshi Ishiwatari 1 , Hiroyuki Matsubayashi 1 , Hiroyuki Ono 1 1Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Keyword: 早期胃癌 , 内視鏡的粘膜下層剝離術 , ESD , 内視鏡的根治度B , 内視鏡的根治度C-2 , リスク評価 pp.81-88
Published Date 2021/1/25
DOI https://doi.org/10.11477/mf.1403202230
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 We retrospectively reviewed the data of patients diagnosed curability B(pT1b SM1)and curability C-2 and investigated long-term outcomes using the Kaplan−Meier method. A total of 197 patients were diagnosed curability B(pT1b SM1) ; the 5-year OS(overall survival)was 87.4%, and the 10-year DSS(disease-specific survival)was 96.8%. A total of 814 patients were diagnosed curability C-2. We compared the 5-year OS and 5-year DSS between patients undergoing radical surgery and those with no additional treatment. The 5-year OS rates in patients undergoing radical surgery and those with no additional treatment were 90.5% and 87.2%, respectively(p<0.01). However, the respective 5-year DSS rates were 98.0% and 97.6%, and there was no significant difference(p=0.53). Therefore, we classified the DSS into three groups using the eCura system. Accordingly, the 5-year DSS rates in patients undergoing radical surgery and those with additional treatment in the low-risk, intermediate-risk, and high-risk categories were 99.1% and 100%, 98.5% and 94.8%, and 94.0% and 87.2%, respectively. The 5-year DSS rates in patients with no additional treatment in the intermediate- and high-risk categories were lower than those in patients undergoing radical surgery. With an increase in the risk score of the eCura system, the risk for gastric cancer-related death also increased. Therefore, the eCura system is useful for selecting additional treatment after diagnosed curability C-2.

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