Predictive Factors and Long-Term Outcomes of Early Gastric Carcinomas in Patients with Non-Curative Resection by Endoscopic Submucosal Dissection
Ping Xu,1,2,* Yun Wang,1,* Yini Dang,1,* Qin Huang,3 Jianhua Wang,2 Weifeng Zhang,1 Yifeng Zhang,4 Guoxin Zhang1 1Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Gastroenterology, Yanc...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-09-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/predictive-factors-and-long-term-outcomes-of-early-gastric-carcinomas--peer-reviewed-article-CMAR |
| _version_ | 1818922512301424640 |
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| author | Xu P Wang Y Dang Y Huang Q Wang J Zhang W Zhang Y Zhang G |
| author_facet | Xu P Wang Y Dang Y Huang Q Wang J Zhang W Zhang Y Zhang G |
| author_sort | Xu P |
| collection | DOAJ |
| description | Ping Xu,1,2,* Yun Wang,1,* Yini Dang,1,* Qin Huang,3 Jianhua Wang,2 Weifeng Zhang,1 Yifeng Zhang,4 Guoxin Zhang1 1Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Gastroenterology, Yancheng City No.1 People’s Hospital, Yancheng, Jiangsu, People’s Republic of China; 3Department of Pathology and Laboratory Medicine, VA Boston Healthcare System and Harvard Medical School, Boston, MA, USA; 4Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guoxin Zhang Department of GastroenterologyThe First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of ChinaEmail guoxinz@njmu.edu.cnQin HuangDepartment of Pathology and Laboratory Medicine, VA Boston Healthcare System, MA 02132, USA, Tel +1 857-203-5020Fax +1 857-203-5623Email qinhuang0122@gmail.comPurpose: Non-curative resection (NCR) remains problematic in some cases of early gastric carcinomas (EGCs) treated by endoscopic submucosal dissection (ESD). The aim of this study was to identify predictors of NCR, especially of eCura C1 and eCura C2 resections, before ESD and study long-term outcomes of EGC patients with NCR.Patients and Methods: A retrospective review of medical records was conducted over an 8-year period for EGCs undergoing ESD. Clinicopathologic and endoscopic characteristics and patients’ survival were analyzed. Risk factors for NCR and eCura C1 and C2 resections were assessed by logistic analyses. Survival of patients was estimated with the Kaplan–Meier method with a Log rank test.Results: A total of 463 patients with 472 lesions were qualified. By univariate and multivariate analyses, the predictors for NCR and eCura C2 resections were tumor size > 20 mm, tumors located in cardia-fundus, uneven surface, margin elevation, and mixed and undifferentiated types, and those for eCura C1 resection were tumors located in cardia-fundus, negative lifting sign, and mixed and undifferentiated types. The 5-year cancer-specific and cancer-free survival rates were 100.0% and 94.2%, and 95.3% and 83.4% in the curative resection (CR) and NCR groups, respectively. The 5-year cancer-specific and cancer-free survival rates were significantly greater in the CR group than that in the NCR group (P < 0.0001).Conclusion: In this cohort, we identified various endoscopic and pathologic features of EGCs to predict NCR, especially eCura C1 and eCura C2 resections before ESD. These clinically valuable factors would be very informative to endoscopists and surgeons who perform ESD to resect EGCs.Keywords: early gastric carcinoma, endoscopic submucosal dissection, non-curative resection, long-term outcome, stomach |
| first_indexed | 2024-12-20T01:54:43Z |
| format | Article |
| id | doaj.art-0301e545968246b18434f9da42d718f3 |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-20T01:54:43Z |
| publishDate | 2020-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-0301e545968246b18434f9da42d718f32022-12-21T19:57:32ZengDove Medical PressCancer Management and Research1179-13222020-09-01Volume 128037804656766Predictive Factors and Long-Term Outcomes of Early Gastric Carcinomas in Patients with Non-Curative Resection by Endoscopic Submucosal DissectionXu PWang YDang YHuang QWang JZhang WZhang YZhang GPing Xu,1,2,* Yun Wang,1,* Yini Dang,1,* Qin Huang,3 Jianhua Wang,2 Weifeng Zhang,1 Yifeng Zhang,4 Guoxin Zhang1 1Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Gastroenterology, Yancheng City No.1 People’s Hospital, Yancheng, Jiangsu, People’s Republic of China; 3Department of Pathology and Laboratory Medicine, VA Boston Healthcare System and Harvard Medical School, Boston, MA, USA; 4Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guoxin Zhang Department of GastroenterologyThe First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of ChinaEmail guoxinz@njmu.edu.cnQin HuangDepartment of Pathology and Laboratory Medicine, VA Boston Healthcare System, MA 02132, USA, Tel +1 857-203-5020Fax +1 857-203-5623Email qinhuang0122@gmail.comPurpose: Non-curative resection (NCR) remains problematic in some cases of early gastric carcinomas (EGCs) treated by endoscopic submucosal dissection (ESD). The aim of this study was to identify predictors of NCR, especially of eCura C1 and eCura C2 resections, before ESD and study long-term outcomes of EGC patients with NCR.Patients and Methods: A retrospective review of medical records was conducted over an 8-year period for EGCs undergoing ESD. Clinicopathologic and endoscopic characteristics and patients’ survival were analyzed. Risk factors for NCR and eCura C1 and C2 resections were assessed by logistic analyses. Survival of patients was estimated with the Kaplan–Meier method with a Log rank test.Results: A total of 463 patients with 472 lesions were qualified. By univariate and multivariate analyses, the predictors for NCR and eCura C2 resections were tumor size > 20 mm, tumors located in cardia-fundus, uneven surface, margin elevation, and mixed and undifferentiated types, and those for eCura C1 resection were tumors located in cardia-fundus, negative lifting sign, and mixed and undifferentiated types. The 5-year cancer-specific and cancer-free survival rates were 100.0% and 94.2%, and 95.3% and 83.4% in the curative resection (CR) and NCR groups, respectively. The 5-year cancer-specific and cancer-free survival rates were significantly greater in the CR group than that in the NCR group (P < 0.0001).Conclusion: In this cohort, we identified various endoscopic and pathologic features of EGCs to predict NCR, especially eCura C1 and eCura C2 resections before ESD. These clinically valuable factors would be very informative to endoscopists and surgeons who perform ESD to resect EGCs.Keywords: early gastric carcinoma, endoscopic submucosal dissection, non-curative resection, long-term outcome, stomachhttps://www.dovepress.com/predictive-factors-and-long-term-outcomes-of-early-gastric-carcinomas--peer-reviewed-article-CMARearly gastric carcinoma · endoscopic submucosal dissection · non-curative resection · long-term outcome · stomach |
| spellingShingle | Xu P Wang Y Dang Y Huang Q Wang J Zhang W Zhang Y Zhang G Predictive Factors and Long-Term Outcomes of Early Gastric Carcinomas in Patients with Non-Curative Resection by Endoscopic Submucosal Dissection Cancer Management and Research early gastric carcinoma · endoscopic submucosal dissection · non-curative resection · long-term outcome · stomach |
| title | Predictive Factors and Long-Term Outcomes of Early Gastric Carcinomas in Patients with Non-Curative Resection by Endoscopic Submucosal Dissection |
| title_full | Predictive Factors and Long-Term Outcomes of Early Gastric Carcinomas in Patients with Non-Curative Resection by Endoscopic Submucosal Dissection |
| title_fullStr | Predictive Factors and Long-Term Outcomes of Early Gastric Carcinomas in Patients with Non-Curative Resection by Endoscopic Submucosal Dissection |
| title_full_unstemmed | Predictive Factors and Long-Term Outcomes of Early Gastric Carcinomas in Patients with Non-Curative Resection by Endoscopic Submucosal Dissection |
| title_short | Predictive Factors and Long-Term Outcomes of Early Gastric Carcinomas in Patients with Non-Curative Resection by Endoscopic Submucosal Dissection |
| title_sort | predictive factors and long term outcomes of early gastric carcinomas in patients with non curative resection by endoscopic submucosal dissection |
| topic | early gastric carcinoma · endoscopic submucosal dissection · non-curative resection · long-term outcome · stomach |
| url | https://www.dovepress.com/predictive-factors-and-long-term-outcomes-of-early-gastric-carcinomas--peer-reviewed-article-CMAR |
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