Endoscopy 2019; 51(04): S105-S106
DOI: 10.1055/s-0039-1681481
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 11:00 – 13:00: ESD stomach 2 Club A
Georg Thieme Verlag KG Stuttgart · New York

LONG TERM SURVIVAL OF EARLY GASTRIC CANCER WITH SUBMUCOSAL INVASION AFTER ESD

Y Takagi
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka, Japan
,
K Yamamoto
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka, Japan
,
T Michida
2   Saitama Medical Center, Department of Gastroenterology, Saitama, Japan
,
Y Sato
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka, Japan
,
Y Tokuda
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka, Japan
,
N Tatsumi
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka, Japan
,
T Ito
1   Japan Community Healthcare Organization Osaka Hospital, Department of Gastroenterology, Osaka, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 
 

    Aims:

    Clinical outcome of early gastric cancer (EGC) with submucosal (SM) invasion after endoscopic submucosal dissection (ESD) is not fully elucidated. Additional surgery may decrease the mortality by lymph node metastasis, but can be an overtreatment for some patients with SM invasion gastric cancer. We investigated the clinical outcome for SM invasion gastric cancer after ESD.

    Methods:

    ESD was performed for 1559 lesions of EGC at our hospital between July 2006 to August 2018. 145 lesions were histopathologically diagnosed as tubular adenocarcinoma with submucosal invasion. Based on the Japanese guideline, we recommended the patients to undergo radical surgery or be followed up without additional treatment. Concretely, the patients whose histopathological findings revealed SM invasion depth were shallower than 500 µm, lymphatic and vascular invasion were negative, and horizontal and vertical margin were negative were followed up without additional treatment. Other patients were recommended to undergo radical surgery. Patients were divided into radical surgery group (n = 76) and no additional treatment group (n = 70). We retrospectively analyzed the disease-specific survival (DSS) and disease-free survival (DFS) in both groups.

    Results:

    3 year and 5 year DSS are 98.4% and 98.4% in radical surgery group, and 100% and 100% in no additional treatment group. 3 year and 5 year DFS were 97.4% and 97.4% in radical surgery group, and 98.1% and 98.1% in no additional treatment group, respectively. There are no statistically significant differences between the radical surgery group and no additional treatment group in DSS and DFS. Local recurrence rate was 2.6% in the radical surgery group and 1.4% in no additional treatment group.

    Conclusions:

    This study demonstrates that the patients of SM invasion gastric cancer after ESD revealed high long term survival. The decision of treatment strategy based on the Japanese guideline seemed to be appropriate for SM invasion gastric cancer.


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