Yung-Yu Hsieh1,2, I-Lin Lee3, Kuo-Liang Wei1,2, Te-Sheng Chang1, Shui-Yi Tung1,2, Cheng-Shyong Wu1, Yi-Hsiung Lin4
1Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Chiayi, Taiwan
2College of Medicine, Chang Gung University, Taoyuan, Taiwan
3Lee’s Endoscopic Clinic, Taipei, Taiwan
4Department of Health Care Administration, Taiwan Shoufu University, Tainan, Taiwan
Tóm tắt
SummaryBackgroundLimited data are available on the interval of disease‐free status after endoscopic submucosal dissection (ESD) for early gastric cancer and precancer lesion in Taiwan. In this long‐term (2–105 months) follow‐up study, we analyzed the risk factors that affect the local recurrence and noncurative resection (non‐CR) of these lesions.MethodsWe retrospectively studied 65 consecutive treatment‐naïve patients with 69 EGC lesions who were selected to be treated by ESD. A total of 56 lesions (48 CR lesions and 8 non‐CR lesions) were analyzed for local recurrence after ESD.Results and DiscussionESD was curative for gastric epithelial tumors in 51 (73.9%) but not in 18 (26.1%) lesions. Unfortunately, five (8.93%) of these 56 lesions in 53 patients had local recurrence. None of the patients died from gastric cancer‐associated diseases during follow‐up. In our studies, the cumulative local recurrence rates were 5.3% in the CR group and 56.7% in the non‐CR group (p = 0.0091). The disease‐free status was high (94.7%) with CR. The risk factors that affect the non‐CR were tumor location (p = 0.013), deeper invasion (p < 0.001), undifferentiated histopathology (p < 0.001), and ulcer presence (p = 0.045).ConclusionESD offers good outcome after treatment for EGC. To decrease the risk of local recurrence, preoperative diagnosis of tumor extent and accurate postoperative pathological evaluation are very important.
