Short-term outcomes of multicenter prospective cohort study of gastric endoscopic resection: 'real-world evidence' in Japan

Haruhisa Suzuki, Kohei Takizawa, Toshiaki Hirasawa, Yoji Takeuchi, Kenji Ishido, Shu Hoteya, Tomonori Yano, Shinji Tanaka, Masaki Endo, Masahiro Nakagawa, Takashi Toyonaga, Hisashi Doyama, Kingo Hirasawa, Mitsuru Matsuda, Hironori Yamamoto, Mitsuhiro Fujishiro, Satoru Hashimoto, Yuki Maeda, Tsuneo Oyama, Ryuta TakenakaYoshinobu Yamamoto, Yuji Naito, Tomoki Michida, Nozomu Kobayashi, Yoshiro Kawahara, Masaaki Hirano, Mario Jin, Shinichiro Hori, Yasumasa Niwa, Takuto Hikichi, Taichi Shimazu, Hiroyuki Ono, Satoshi Tanabe, Hitoshi Kondo, Hiroyasu Iishi, Motoki Ninomiya, Ichiro Oda

Research output: Contribution to journalReview article

Abstract

Objectives: A Japanese multicenter prospective cohort study examining endoscopic resection (ER) for early gastric cancer (EGC) has been conducted using a Web registry developed to determine the short-term and long-term outcomes based on absolute and expanded indications. We hereby present the short-term outcomes of this study. Methods: All consecutive patients with EGC or suspected EGC undergoing ER at 41 participating institutions between July 2010 and June 2012 were enrolled and prospectively registered into the Web registry. The baseline characteristics were entered before ER, and the short-term outcomes were collected at 6 months following ER. Results: Nine thousand six hundred and sixteen patients with 10,821 lesions underwent ER (endoscopic submucosal dissection [ESD]: 99.4%). The median procedure time was 76 min, and R0 resections were achieved for 91.6% of the lesions. Postoperative bleeding and intraoperative perforation occurred in 4.4% and 2.3% of the patients, respectively. Significant independent factors correlated with a longer procedure time (120 min or longer) were as follows: Tumor size > 20 mm, upperthird location, middle-third location, local recurrent lesion, ulcer findings, gastric tube, male gender, and submucosa. Histopathologically, 10,031 lesions were identified as common-type gastric cancers. The median tumor size was 15 mm. Noncurative resections were diagnosed for 18.3% of the lesions. Additional surgery was performed for 48.6% (824 lesions) of the 1,695 noncurative ER lesions with a possible risk of lymph node (LN) metastasis. Among them, 64 (7.8%) exhibited LN metastasis. Conclusions: This multicenter prospective study showed favorable short-term outcomes for gastric ESD.

Original languageEnglish
Pages (from-to)2397-2408
Number of pages12
JournalGASTROENTEROLOGICAL ENDOSCOPY
Volume61
Issue number10
DOIs
Publication statusPublished - Jan 1 2019

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Stomach Neoplasms
Stomach
Japan
Cohort Studies
Prospective Studies
Registries
Lymph Nodes
Neoplasm Metastasis
Stomach Ulcer
Multicenter Studies
Neoplasms
Outcome Assessment (Health Care)
Hemorrhage
Endoscopic Mucosal Resection

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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Short-term outcomes of multicenter prospective cohort study of gastric endoscopic resection : 'real-world evidence' in Japan. / Suzuki, Haruhisa; Takizawa, Kohei; Hirasawa, Toshiaki; Takeuchi, Yoji; Ishido, Kenji; Hoteya, Shu; Yano, Tomonori; Tanaka, Shinji; Endo, Masaki; Nakagawa, Masahiro; Toyonaga, Takashi; Doyama, Hisashi; Hirasawa, Kingo; Matsuda, Mitsuru; Yamamoto, Hironori; Fujishiro, Mitsuhiro; Hashimoto, Satoru; Maeda, Yuki; Oyama, Tsuneo; Takenaka, Ryuta; Yamamoto, Yoshinobu; Naito, Yuji; Michida, Tomoki; Kobayashi, Nozomu; Kawahara, Yoshiro; Hirano, Masaaki; Jin, Mario; Hori, Shinichiro; Niwa, Yasumasa; Hikichi, Takuto; Shimazu, Taichi; Ono, Hiroyuki; Tanabe, Satoshi; Kondo, Hitoshi; Iishi, Hiroyasu; Ninomiya, Motoki; Oda, Ichiro.

In: GASTROENTEROLOGICAL ENDOSCOPY, Vol. 61, No. 10, 01.01.2019, p. 2397-2408.

Research output: Contribution to journalReview article

Suzuki, H, Takizawa, K, Hirasawa, T, Takeuchi, Y, Ishido, K, Hoteya, S, Yano, T, Tanaka, S, Endo, M, Nakagawa, M, Toyonaga, T, Doyama, H, Hirasawa, K, Matsuda, M, Yamamoto, H, Fujishiro, M, Hashimoto, S, Maeda, Y, Oyama, T, Takenaka, R, Yamamoto, Y, Naito, Y, Michida, T, Kobayashi, N, Kawahara, Y, Hirano, M, Jin, M, Hori, S, Niwa, Y, Hikichi, T, Shimazu, T, Ono, H, Tanabe, S, Kondo, H, Iishi, H, Ninomiya, M & Oda, I 2019, 'Short-term outcomes of multicenter prospective cohort study of gastric endoscopic resection: 'real-world evidence' in Japan', GASTROENTEROLOGICAL ENDOSCOPY, vol. 61, no. 10, pp. 2397-2408. https://doi.org/10.11280/gee.61.2397
Suzuki, Haruhisa ; Takizawa, Kohei ; Hirasawa, Toshiaki ; Takeuchi, Yoji ; Ishido, Kenji ; Hoteya, Shu ; Yano, Tomonori ; Tanaka, Shinji ; Endo, Masaki ; Nakagawa, Masahiro ; Toyonaga, Takashi ; Doyama, Hisashi ; Hirasawa, Kingo ; Matsuda, Mitsuru ; Yamamoto, Hironori ; Fujishiro, Mitsuhiro ; Hashimoto, Satoru ; Maeda, Yuki ; Oyama, Tsuneo ; Takenaka, Ryuta ; Yamamoto, Yoshinobu ; Naito, Yuji ; Michida, Tomoki ; Kobayashi, Nozomu ; Kawahara, Yoshiro ; Hirano, Masaaki ; Jin, Mario ; Hori, Shinichiro ; Niwa, Yasumasa ; Hikichi, Takuto ; Shimazu, Taichi ; Ono, Hiroyuki ; Tanabe, Satoshi ; Kondo, Hitoshi ; Iishi, Hiroyasu ; Ninomiya, Motoki ; Oda, Ichiro. / Short-term outcomes of multicenter prospective cohort study of gastric endoscopic resection : 'real-world evidence' in Japan. In: GASTROENTEROLOGICAL ENDOSCOPY. 2019 ; Vol. 61, No. 10. pp. 2397-2408.
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title = "Short-term outcomes of multicenter prospective cohort study of gastric endoscopic resection: 'real-world evidence' in Japan",
abstract = "Objectives: A Japanese multicenter prospective cohort study examining endoscopic resection (ER) for early gastric cancer (EGC) has been conducted using a Web registry developed to determine the short-term and long-term outcomes based on absolute and expanded indications. We hereby present the short-term outcomes of this study. Methods: All consecutive patients with EGC or suspected EGC undergoing ER at 41 participating institutions between July 2010 and June 2012 were enrolled and prospectively registered into the Web registry. The baseline characteristics were entered before ER, and the short-term outcomes were collected at 6 months following ER. Results: Nine thousand six hundred and sixteen patients with 10,821 lesions underwent ER (endoscopic submucosal dissection [ESD]: 99.4{\%}). The median procedure time was 76 min, and R0 resections were achieved for 91.6{\%} of the lesions. Postoperative bleeding and intraoperative perforation occurred in 4.4{\%} and 2.3{\%} of the patients, respectively. Significant independent factors correlated with a longer procedure time (120 min or longer) were as follows: Tumor size > 20 mm, upperthird location, middle-third location, local recurrent lesion, ulcer findings, gastric tube, male gender, and submucosa. Histopathologically, 10,031 lesions were identified as common-type gastric cancers. The median tumor size was 15 mm. Noncurative resections were diagnosed for 18.3{\%} of the lesions. Additional surgery was performed for 48.6{\%} (824 lesions) of the 1,695 noncurative ER lesions with a possible risk of lymph node (LN) metastasis. Among them, 64 (7.8{\%}) exhibited LN metastasis. Conclusions: This multicenter prospective study showed favorable short-term outcomes for gastric ESD.",
author = "Haruhisa Suzuki and Kohei Takizawa and Toshiaki Hirasawa and Yoji Takeuchi and Kenji Ishido and Shu Hoteya and Tomonori Yano and Shinji Tanaka and Masaki Endo and Masahiro Nakagawa and Takashi Toyonaga and Hisashi Doyama and Kingo Hirasawa and Mitsuru Matsuda and Hironori Yamamoto and Mitsuhiro Fujishiro and Satoru Hashimoto and Yuki Maeda and Tsuneo Oyama and Ryuta Takenaka and Yoshinobu Yamamoto and Yuji Naito and Tomoki Michida and Nozomu Kobayashi and Yoshiro Kawahara and Masaaki Hirano and Mario Jin and Shinichiro Hori and Yasumasa Niwa and Takuto Hikichi and Taichi Shimazu and Hiroyuki Ono and Satoshi Tanabe and Hitoshi Kondo and Hiroyasu Iishi and Motoki Ninomiya and Ichiro Oda",
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TY - JOUR

T1 - Short-term outcomes of multicenter prospective cohort study of gastric endoscopic resection

T2 - 'real-world evidence' in Japan

AU - Suzuki, Haruhisa

AU - Takizawa, Kohei

AU - Hirasawa, Toshiaki

AU - Takeuchi, Yoji

AU - Ishido, Kenji

AU - Hoteya, Shu

AU - Yano, Tomonori

AU - Tanaka, Shinji

AU - Endo, Masaki

AU - Nakagawa, Masahiro

AU - Toyonaga, Takashi

AU - Doyama, Hisashi

AU - Hirasawa, Kingo

AU - Matsuda, Mitsuru

AU - Yamamoto, Hironori

AU - Fujishiro, Mitsuhiro

AU - Hashimoto, Satoru

AU - Maeda, Yuki

AU - Oyama, Tsuneo

AU - Takenaka, Ryuta

AU - Yamamoto, Yoshinobu

AU - Naito, Yuji

AU - Michida, Tomoki

AU - Kobayashi, Nozomu

AU - Kawahara, Yoshiro

AU - Hirano, Masaaki

AU - Jin, Mario

AU - Hori, Shinichiro

AU - Niwa, Yasumasa

AU - Hikichi, Takuto

AU - Shimazu, Taichi

AU - Ono, Hiroyuki

AU - Tanabe, Satoshi

AU - Kondo, Hitoshi

AU - Iishi, Hiroyasu

AU - Ninomiya, Motoki

AU - Oda, Ichiro

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: A Japanese multicenter prospective cohort study examining endoscopic resection (ER) for early gastric cancer (EGC) has been conducted using a Web registry developed to determine the short-term and long-term outcomes based on absolute and expanded indications. We hereby present the short-term outcomes of this study. Methods: All consecutive patients with EGC or suspected EGC undergoing ER at 41 participating institutions between July 2010 and June 2012 were enrolled and prospectively registered into the Web registry. The baseline characteristics were entered before ER, and the short-term outcomes were collected at 6 months following ER. Results: Nine thousand six hundred and sixteen patients with 10,821 lesions underwent ER (endoscopic submucosal dissection [ESD]: 99.4%). The median procedure time was 76 min, and R0 resections were achieved for 91.6% of the lesions. Postoperative bleeding and intraoperative perforation occurred in 4.4% and 2.3% of the patients, respectively. Significant independent factors correlated with a longer procedure time (120 min or longer) were as follows: Tumor size > 20 mm, upperthird location, middle-third location, local recurrent lesion, ulcer findings, gastric tube, male gender, and submucosa. Histopathologically, 10,031 lesions were identified as common-type gastric cancers. The median tumor size was 15 mm. Noncurative resections were diagnosed for 18.3% of the lesions. Additional surgery was performed for 48.6% (824 lesions) of the 1,695 noncurative ER lesions with a possible risk of lymph node (LN) metastasis. Among them, 64 (7.8%) exhibited LN metastasis. Conclusions: This multicenter prospective study showed favorable short-term outcomes for gastric ESD.

AB - Objectives: A Japanese multicenter prospective cohort study examining endoscopic resection (ER) for early gastric cancer (EGC) has been conducted using a Web registry developed to determine the short-term and long-term outcomes based on absolute and expanded indications. We hereby present the short-term outcomes of this study. Methods: All consecutive patients with EGC or suspected EGC undergoing ER at 41 participating institutions between July 2010 and June 2012 were enrolled and prospectively registered into the Web registry. The baseline characteristics were entered before ER, and the short-term outcomes were collected at 6 months following ER. Results: Nine thousand six hundred and sixteen patients with 10,821 lesions underwent ER (endoscopic submucosal dissection [ESD]: 99.4%). The median procedure time was 76 min, and R0 resections were achieved for 91.6% of the lesions. Postoperative bleeding and intraoperative perforation occurred in 4.4% and 2.3% of the patients, respectively. Significant independent factors correlated with a longer procedure time (120 min or longer) were as follows: Tumor size > 20 mm, upperthird location, middle-third location, local recurrent lesion, ulcer findings, gastric tube, male gender, and submucosa. Histopathologically, 10,031 lesions were identified as common-type gastric cancers. The median tumor size was 15 mm. Noncurative resections were diagnosed for 18.3% of the lesions. Additional surgery was performed for 48.6% (824 lesions) of the 1,695 noncurative ER lesions with a possible risk of lymph node (LN) metastasis. Among them, 64 (7.8%) exhibited LN metastasis. Conclusions: This multicenter prospective study showed favorable short-term outcomes for gastric ESD.

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DO - 10.11280/gee.61.2397

M3 - Review article

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JO - Gastroenterological Endoscopy

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