TY - JOUR
T1 - Efficacy and safety of endoscopic submucosal dissection for gastric tube cancer
T2 - A multicenter retrospective study
AU - Satomi, Takuya
AU - Kawano, Seiji
AU - Inaba, Tomoki
AU - Nakagawa, Masahiro
AU - Mouri, Hirokazu
AU - Yoshioka, Masao
AU - Tanaka, Shoichi
AU - Toyokawa, Tatsuya
AU - Kobayashi, Sayo
AU - Tanaka, Takehiro
AU - Kanzaki, Hiromitsu
AU - Iwamuro, Masaya
AU - Kawahara, Yoshiro
AU - Okada, Hiroyuki
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2021/3/21
Y1 - 2021/3/21
N2 - BACKGROUND Recent improvements in the prognosis of patients with esophageal cancer have led to the increased occurrence of gastric tube cancer (GTC) in the reconstructed gastric tube. However, there are few reports on the treatment results of endoscopic submucosal dissection (ESD) for GTC. AIM To evaluate the efficacy and safety of ESD for GTC after esophagectomy in a multicenter trial. METHODS We retrospectively investigated 48 GTC lesions in 38 consecutive patients with GTC in the reconstructed gastric tube after esophagectomy who had undergone ESD between January 2005 and December 2019 at 8 institutions participating in the Okayama Gut Study group. The clinical indications of ESD for early gastric cancer were similarly applied for GTC after esophagectomy. ESD specimens were evaluated in 2-mm slices according to the Japanese Classification of Gastric Carcinoma with curability assessments divided into curative and non-curative resection based on the Gastric Cancer Treatment Guidelines. Patient characteristics, treatment results, clinical course, and treatment outcomes were analyzed. RESULTS The median age of patients was 71.5 years (range, 57-84years), and there were 34 men and 4 women. The median observation period after ESD was 884 d (range, 8- 4040 d). The median procedure time was 81 min (range, 29-334 min), the en bloc resection rate was 91.7% (44/48), and the curative resection rate was 79% (38/48). Complications during ESD were seen in 4% (2/48) of case, and those after ESD were seen in 10% (5/48) of case. The survival rate at 5 years was 59.5%. During the observation period after ESD, 10 patients died of other diseases. Although there were differences in the procedure time between institutions, a multivariate analysis showed that tumor size was the only factor associated with prolonged procedure time. CONCLUSION ESD for GTC after esophagectomy was shown to be safe and effective.
AB - BACKGROUND Recent improvements in the prognosis of patients with esophageal cancer have led to the increased occurrence of gastric tube cancer (GTC) in the reconstructed gastric tube. However, there are few reports on the treatment results of endoscopic submucosal dissection (ESD) for GTC. AIM To evaluate the efficacy and safety of ESD for GTC after esophagectomy in a multicenter trial. METHODS We retrospectively investigated 48 GTC lesions in 38 consecutive patients with GTC in the reconstructed gastric tube after esophagectomy who had undergone ESD between January 2005 and December 2019 at 8 institutions participating in the Okayama Gut Study group. The clinical indications of ESD for early gastric cancer were similarly applied for GTC after esophagectomy. ESD specimens were evaluated in 2-mm slices according to the Japanese Classification of Gastric Carcinoma with curability assessments divided into curative and non-curative resection based on the Gastric Cancer Treatment Guidelines. Patient characteristics, treatment results, clinical course, and treatment outcomes were analyzed. RESULTS The median age of patients was 71.5 years (range, 57-84years), and there were 34 men and 4 women. The median observation period after ESD was 884 d (range, 8- 4040 d). The median procedure time was 81 min (range, 29-334 min), the en bloc resection rate was 91.7% (44/48), and the curative resection rate was 79% (38/48). Complications during ESD were seen in 4% (2/48) of case, and those after ESD were seen in 10% (5/48) of case. The survival rate at 5 years was 59.5%. During the observation period after ESD, 10 patients died of other diseases. Although there were differences in the procedure time between institutions, a multivariate analysis showed that tumor size was the only factor associated with prolonged procedure time. CONCLUSION ESD for GTC after esophagectomy was shown to be safe and effective.
KW - Endoscopic submucosal dissection
KW - Esophagectomy
KW - Gastric cancer
KW - Gastric tube
KW - Multicenter study
KW - Retrospective study
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U2 - 10.3748/wjg.v27.i11.1043
DO - 10.3748/wjg.v27.i11.1043
M3 - Article
C2 - 33776371
AN - SCOPUS:85103069463
VL - 27
SP - 1043
EP - 1054
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 11
ER -