Long-Term Outcomes of Endoscopic Submucosal Dissection for Early Remnant Gastric Cancer: A Retrospective Multicenter Study

Author:

Tsuda KazunoriORCID,Tanaka Shinwa,Yoshizaki TetsuyaORCID,Yamamoto Yoshinobu,Ose Takayuki,Ishida Tsukasa,Kitamura Yasuaki,Obata Daisuke,Iwatate Mineo,Ikeda Atsushi,Ariyoshi Ryusuke,Kawara Fumiaki,Takihara Hiroshi,Abe Hirofumi,Takao ToshitatsuORCID,Morita Yoshinori,Sano YasushiORCID,Umegaki EijiORCID,Nishisaki HogaraORCID,Toyonaga Takashi,Kodama Yuzo

Abstract

Introduction: Favorable long-term outcomes of endoscopic submucosal dissection (ESD) for early remnant gastric cancer (ERGC) have been reported in single-center studies from advanced institutions. However, no studies have examined the long-term outcomes using a multicenter database. This study aimed to investigate the long-term outcomes of the aforementioned approach using a large multicenter database. Methods: This retrospective multicenter cohort study included 242 cases with 256 lesions that underwent ESD for ERGC between April 2009 and March 2019 across 12 centers. We investigated the long-term outcomes of these patients with the Kaplan-Meier method, and the relationship between curability, additional treatment, or hospital category, and the survival time was evaluated using the log-rank test. Results: During the median follow-up period of 48.4 months, the 5-year overall survival rate was 81.3%, and the 5-year gastric cancer-specific survival rate was 98.1%. The survival time of patients of endoscopic curability (eCura) C-2 without additional surgery was significantly shorter than the corresponding of patients of eCura A/B/C-1 and eCura C-2 with additional surgery. There was no significant difference in either overall survival or gastric cancer-specific survival rate between the high-volume and non-high-volume hospitals. Conclusion: The gastric cancer-specific survival of ESD for ERGC using a multicenter database was favorable. ESD for ERGC is widely applicable regardless of the hospital case volume. Management in accordance with the latest guidelines will lead to long-term survival.

Publisher

S. Karger AG

Subject

Gastroenterology

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