Suitability of the expanded indication criteria for the treatment of early gastric cancer by endoscopic submucosal dissection

Japanese multicenter large-scale retrospective analysis of short- and long-term outcomes

Kazuhiko Nakamura, Kuniomi Honda, Kazuya Akahoshi, Eikichi Ihara, Hiroshi Matsuzaka, Yorinobu Sumida, Daisuke Yoshimura, Hirotada Akiho, Yasuaki Motomura, tsutomu iwasa, Keishi Komori, Yoshiharu Chijiiwa, Naohiko Harada, Toshiaki Ochiai, Masafumi Oya, Yoshinao Oda, Ryoichi Takayanagi

研究成果: ジャーナルへの寄稿記事

20 引用 (Scopus)

抄録

Objective. The criteria for endoscopic resection for early gastric cancer include absolute and expanded indications. Consensus already exists for the absolute indications. However, the suitability of the expanded indications must be validated by long-term outcome analyses since such lesions have only recently become resectable with the development of endoscopic submucosal dissection. The aim of this study is to clarify the suitability of the expanded indications for the treatment of early gastric cancer with endoscopic submucosal dissection. Materials and methods. The medical records of 1161 patients with early gastric cancers (1332 lesions) treated by endoscopic submucosal dissection and meeting the criteria for absolute or expanded indications without additional treatment with gastrectomy were divided into absolute indication group or expanded indication group. Results. Complete resection rates were 96.4% and 93.4% in absolute and expanded indication groups, respectively, with no significant differences between the groups. Delayed bleeding rates were significantly higher in the expanded indication group, whereas all cases were successfully managed conservatively. The 5-year overall survival and recurrence-free rates were 93.7%/99.77% and 90.49%/98.90% in the absolute and the expanded indication groups, respectively, with no significant differences between the groups for either measure. Multivariate analyses revealed that affected horizontal margin and tumor location were independent predictive factors for recurrence. Conclusion. The expanded indication group showed excellent post-endoscopic submucosal dissection short-term and long-term outcomes compared with the absolute indications group, demonstrating that expanded indications are suitable for endoscopic submucosal dissection for early gastric cancer.

元の言語英語
ページ(範囲)413-422
ページ数10
ジャーナルScandinavian Journal of Gastroenterology
50
発行部数4
DOI
出版物ステータス出版済み - 4 1 2015

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Stomach Neoplasms
Therapeutics
Recurrence
Gastrectomy
Medical Records
Multivariate Analysis
Endoscopic Mucosal Resection
Hemorrhage
Survival
Neoplasms

All Science Journal Classification (ASJC) codes

  • Gastroenterology

これを引用

Suitability of the expanded indication criteria for the treatment of early gastric cancer by endoscopic submucosal dissection : Japanese multicenter large-scale retrospective analysis of short- and long-term outcomes. / Nakamura, Kazuhiko; Honda, Kuniomi; Akahoshi, Kazuya; Ihara, Eikichi; Matsuzaka, Hiroshi; Sumida, Yorinobu; Yoshimura, Daisuke; Akiho, Hirotada; Motomura, Yasuaki; iwasa, tsutomu; Komori, Keishi; Chijiiwa, Yoshiharu; Harada, Naohiko; Ochiai, Toshiaki; Oya, Masafumi; Oda, Yoshinao; Takayanagi, Ryoichi.

:: Scandinavian Journal of Gastroenterology, 巻 50, 番号 4, 01.04.2015, p. 413-422.

研究成果: ジャーナルへの寄稿記事

Nakamura, K, Honda, K, Akahoshi, K, Ihara, E, Matsuzaka, H, Sumida, Y, Yoshimura, D, Akiho, H, Motomura, Y, iwasa, T, Komori, K, Chijiiwa, Y, Harada, N, Ochiai, T, Oya, M, Oda, Y & Takayanagi, R 2015, 'Suitability of the expanded indication criteria for the treatment of early gastric cancer by endoscopic submucosal dissection: Japanese multicenter large-scale retrospective analysis of short- and long-term outcomes', Scandinavian Journal of Gastroenterology, 巻. 50, 番号 4, pp. 413-422. https://doi.org/10.3109/00365521.2014.940377
Nakamura, Kazuhiko ; Honda, Kuniomi ; Akahoshi, Kazuya ; Ihara, Eikichi ; Matsuzaka, Hiroshi ; Sumida, Yorinobu ; Yoshimura, Daisuke ; Akiho, Hirotada ; Motomura, Yasuaki ; iwasa, tsutomu ; Komori, Keishi ; Chijiiwa, Yoshiharu ; Harada, Naohiko ; Ochiai, Toshiaki ; Oya, Masafumi ; Oda, Yoshinao ; Takayanagi, Ryoichi. / Suitability of the expanded indication criteria for the treatment of early gastric cancer by endoscopic submucosal dissection : Japanese multicenter large-scale retrospective analysis of short- and long-term outcomes. :: Scandinavian Journal of Gastroenterology. 2015 ; 巻 50, 番号 4. pp. 413-422.
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title = "Suitability of the expanded indication criteria for the treatment of early gastric cancer by endoscopic submucosal dissection: Japanese multicenter large-scale retrospective analysis of short- and long-term outcomes",
abstract = "Objective. The criteria for endoscopic resection for early gastric cancer include absolute and expanded indications. Consensus already exists for the absolute indications. However, the suitability of the expanded indications must be validated by long-term outcome analyses since such lesions have only recently become resectable with the development of endoscopic submucosal dissection. The aim of this study is to clarify the suitability of the expanded indications for the treatment of early gastric cancer with endoscopic submucosal dissection. Materials and methods. The medical records of 1161 patients with early gastric cancers (1332 lesions) treated by endoscopic submucosal dissection and meeting the criteria for absolute or expanded indications without additional treatment with gastrectomy were divided into absolute indication group or expanded indication group. Results. Complete resection rates were 96.4{\%} and 93.4{\%} in absolute and expanded indication groups, respectively, with no significant differences between the groups. Delayed bleeding rates were significantly higher in the expanded indication group, whereas all cases were successfully managed conservatively. The 5-year overall survival and recurrence-free rates were 93.7{\%}/99.77{\%} and 90.49{\%}/98.90{\%} in the absolute and the expanded indication groups, respectively, with no significant differences between the groups for either measure. Multivariate analyses revealed that affected horizontal margin and tumor location were independent predictive factors for recurrence. Conclusion. The expanded indication group showed excellent post-endoscopic submucosal dissection short-term and long-term outcomes compared with the absolute indications group, demonstrating that expanded indications are suitable for endoscopic submucosal dissection for early gastric cancer.",
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T1 - Suitability of the expanded indication criteria for the treatment of early gastric cancer by endoscopic submucosal dissection

T2 - Japanese multicenter large-scale retrospective analysis of short- and long-term outcomes

AU - Nakamura, Kazuhiko

AU - Honda, Kuniomi

AU - Akahoshi, Kazuya

AU - Ihara, Eikichi

AU - Matsuzaka, Hiroshi

AU - Sumida, Yorinobu

AU - Yoshimura, Daisuke

AU - Akiho, Hirotada

AU - Motomura, Yasuaki

AU - iwasa, tsutomu

AU - Komori, Keishi

AU - Chijiiwa, Yoshiharu

AU - Harada, Naohiko

AU - Ochiai, Toshiaki

AU - Oya, Masafumi

AU - Oda, Yoshinao

AU - Takayanagi, Ryoichi

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Objective. The criteria for endoscopic resection for early gastric cancer include absolute and expanded indications. Consensus already exists for the absolute indications. However, the suitability of the expanded indications must be validated by long-term outcome analyses since such lesions have only recently become resectable with the development of endoscopic submucosal dissection. The aim of this study is to clarify the suitability of the expanded indications for the treatment of early gastric cancer with endoscopic submucosal dissection. Materials and methods. The medical records of 1161 patients with early gastric cancers (1332 lesions) treated by endoscopic submucosal dissection and meeting the criteria for absolute or expanded indications without additional treatment with gastrectomy were divided into absolute indication group or expanded indication group. Results. Complete resection rates were 96.4% and 93.4% in absolute and expanded indication groups, respectively, with no significant differences between the groups. Delayed bleeding rates were significantly higher in the expanded indication group, whereas all cases were successfully managed conservatively. The 5-year overall survival and recurrence-free rates were 93.7%/99.77% and 90.49%/98.90% in the absolute and the expanded indication groups, respectively, with no significant differences between the groups for either measure. Multivariate analyses revealed that affected horizontal margin and tumor location were independent predictive factors for recurrence. Conclusion. The expanded indication group showed excellent post-endoscopic submucosal dissection short-term and long-term outcomes compared with the absolute indications group, demonstrating that expanded indications are suitable for endoscopic submucosal dissection for early gastric cancer.

AB - Objective. The criteria for endoscopic resection for early gastric cancer include absolute and expanded indications. Consensus already exists for the absolute indications. However, the suitability of the expanded indications must be validated by long-term outcome analyses since such lesions have only recently become resectable with the development of endoscopic submucosal dissection. The aim of this study is to clarify the suitability of the expanded indications for the treatment of early gastric cancer with endoscopic submucosal dissection. Materials and methods. The medical records of 1161 patients with early gastric cancers (1332 lesions) treated by endoscopic submucosal dissection and meeting the criteria for absolute or expanded indications without additional treatment with gastrectomy were divided into absolute indication group or expanded indication group. Results. Complete resection rates were 96.4% and 93.4% in absolute and expanded indication groups, respectively, with no significant differences between the groups. Delayed bleeding rates were significantly higher in the expanded indication group, whereas all cases were successfully managed conservatively. The 5-year overall survival and recurrence-free rates were 93.7%/99.77% and 90.49%/98.90% in the absolute and the expanded indication groups, respectively, with no significant differences between the groups for either measure. Multivariate analyses revealed that affected horizontal margin and tumor location were independent predictive factors for recurrence. Conclusion. The expanded indication group showed excellent post-endoscopic submucosal dissection short-term and long-term outcomes compared with the absolute indications group, demonstrating that expanded indications are suitable for endoscopic submucosal dissection for early gastric cancer.

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DO - 10.3109/00365521.2014.940377

M3 - Article

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EP - 422

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

IS - 4

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