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Original Article
- Risk Factors and Clinical Outcomes of Non-Curative Resection in Patients with Early Gastric Cancer Treated with Endoscopic Submucosal Dissection: A Retrospective Multicenter Study in Korea
- Si Hyung Lee, Min Cheol Kim, Seong Woo Jeon, Kang Nyeong Lee, Jong Jae Park, Su Jin Hong, Korean Society of Gastrointestinal Endoscopy Endoscopic Submucosal Dissection Research Group
- Clin Endosc 2020;53(2):196-205. Published online October 25, 2019
- DOI: https://doi.org/10.5946/ce.2019.123
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Abstract
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ePub - Background
/Aims: The purpose of this study was to investigate the risk factors and long-term clinical outcomes of non-curative resection (NCR) in a large-scale patient population.
Methods
We retrospectively analyzed the clinical data of 3,094 patients who underwent endoscopic submucosal dissection (ESD) of early gastric cancer from March 2005 to March 2018 at 13 institutions in Korea. We analyzed the risk factors for NCR and the survival between patients with curative resection and those with NCR with no additional treatment.
Results
The NCR rate was 21.4% (661/3,094). In multivariate regression analysis, the risk factors affecting NCR with ESD were old age, undifferentiated tumor, tumor location in the upper body, tumor size ≥2 cm, and presence of an ulcer. In Cox proportional hazard regression analysis, tumor size ≥2 cm, submucosal invasion, positive horizontal margin, and lymphovascular invasion were risk factors for local recurrence. In Kaplan-Meier analysis, there was no statistically significant difference in the overall survival between the two groups (log-rank p=0.788). However, disease-specific survival was significantly lower in the NCR group (log-rank p=0.038).
Conclusions
Clinicians should be aware of the risk factors for NCR and local recurrence after ESD for early gastric cancer, and should consider providing additional treatment after NCR. -
Citations
Citations to this article as recorded by
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- Management Strategy of Non-curative ESD in Gastric Cancer: Curative Criteria, and the Critical Building Block for Determining Beyond It
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- 22 Crossref
- Usefulness of Giemsa Staining and Campylobacter-Like Organism (CLO) Test Following Helicobacter pylori Eradication Therapy
- Hyo Jung Kim, M.D., Sung Tae Kim, M.D., Sang Woo Lee, M.D., Yoon Tae Jeen, M.D.,Hoon Jai Chun, M.D., Hong Sik Lee, M.D., Chi Wook Song, M.D.,Soon Ho Um, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D.,Ho Sang Ryu, M.D. and Jin Hai Hyun, M.D.
- Korean J Gastrointest Endosc 2001;22(4):202-207. Published online April 30, 2001
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Abstract
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- Background
/Aims: Follow-up studies with low sensitivity and specificity make it difficult to predict precisely long-term effect of H. pylori eradication therapy. The aim of this prospective study was to evaluate the usefulness of Giemsa staining and CLO test following eradication therapy. Methods: In this study, H. pylori eradication therapy was done in 99 consecutive peptic ulcer patients and followed at 1, 6, and 12 months. Follow-up diagnosis was performed by Giemsa staining and CLO test using 6 specimens taken from the gastric antrum and midbody. Eradication was considered if the results of the two tests were negative. Results: Overall the results of 63 (64%) patients among 99 patients who followed more than 6 months did not changed including 9 persistent positive, and 54 negative. However, the result of 36 patients changed to 21 positive and 15 negative conversion after 6 months. The estimated sensitivity, specificity, positive predictive value, negative predictive value of the Giemsa staining and CLO test, using PCR and culture as 'gold standard', were 67%, 85%, 82%, 70%, respectively. Conclusions: Sensitivity and specificity of Giemsa staining and CLO test following eradication therapy are lower than other reports. It is suggested that the large, multicenter prospective study is necessary to prove diagnostic accuracy of those follow-up studies. (Korean J Gastrointest Endosc 2001; 22:202207)
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- 10 Download
- 원저 : 식도 위장관 ; 융모성 종양의 특성과 대책 ( Original Articles : Esophagus , Stomach & Intestine ; Tubulovillous and Villous Adenomas of the Colon and Rectum - Endoscopic Characteristics and Management - )
- Korean J Gastrointest Endosc 1998;18(4):506-519. Published online November 30, 1997
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Abstract
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- Background
/Aims: A villous tumor, histologically villous or tubulovillous adenoma, is a clinical challenge because of its higher potential for malignancy and higher recurrence rate. However, information and experience with these tumors in the Korean people is still lacking. For that reason, we designed this study to review and analyze the colonoscopic features, the potential for malignancy, and the treatiment with respect to the confirmation of guidelines for the accurate diagnosis and reasonable management of such tumors in the Korean population. Materials and Methods: We performed 753 polypectomies, including 4 transanal excisions and several bowel resections, from January 1996 to May 1997 at Song-Do Colorectal Hospital in Seoul, Among them, 447 cases (59.4%) were adenomas, comprising 405 (53.8%) tubular adenomas, 31 (4.1%) tubulovillous adenomas, and 11 (1.5%) villous adenomas. We analyzed the 42 (5.6%) tubulovillous and villous adenomas. (Korean J Gastraintest Endosc 18: 506-519, 1998) (continue)
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- 3 Download
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