Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study
Abstract Background Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used techniques for the treatment of gastric epithelial dysplasia. Previous studies have compared the clinical outcome of endoscopic resection for early gastric cancer, but few studies have f...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Gastroenterology |
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| Online Access: | http://link.springer.com/article/10.1186/s12876-020-01293-0 |
| _version_ | 1818242872832425984 |
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| author | Min Kyung Back Hee Seok Moon In Sun Kwon Jae Ho Park Ju Seok Kim Sun Hyung Kang Jae Kyu Sung Eaum Seok Lee Seok Hyun Kim Byung Seok Lee Hyun Yong Jeong |
| author_facet | Min Kyung Back Hee Seok Moon In Sun Kwon Jae Ho Park Ju Seok Kim Sun Hyung Kang Jae Kyu Sung Eaum Seok Lee Seok Hyun Kim Byung Seok Lee Hyun Yong Jeong |
| author_sort | Min Kyung Back |
| collection | DOAJ |
| description | Abstract Background Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used techniques for the treatment of gastric epithelial dysplasia. Previous studies have compared the clinical outcome of endoscopic resection for early gastric cancer, but few studies have focused on gastric dysplasia alone. This study aimed to evaluate the long-term prognosis following endoscopic procedures for gastric epithelial dysplasia, investigate differences in local recurrence rates according to the treatment modality, and identify risk factors associated with local recurrence. Methods In this retrospective study, local recurrence rates and risk factors associated with local recurrence were compared between 599 patients who underwent EMR and 306 who underwent ESD for gastric epithelial dysplasia from January 2011 to December 2015. Results The en bloc resection rate (32.2% vs. 100%, p < 0.001) and complete resection rate (94.8% vs. 99.0%, p = 0.003) were significantly lower in the EMR group than in the ESD group. The local recurrence rate was significantly lower in the ESD group (1.3%) than in the EMR group (4.2%; p = 0.026). There was a significantly increased risk of local recurrence, regardless of lesion location or histologic grade, in patients with lesions > 2 cm (p = 0.002) or red in color (p = 0.03). The ESD group had a significantly lower local recurrence rate, with a higher complete resection rate, than that in the EMR group (p < 0.05). In the case of recurrence after endoscopic resection, most of the recurred lesions were removed through additional endoscopic procedures; there was no difference between the two groups (p = 0.153). Conclusions The complete resection rate was significantly higher, and the local recurrence rate was significantly lower, in patients with gastric epithelial dysplasia treated with ESD. Therefore, ESD should be considered the preferred treatment in patients with lesions > 2 cm or showing redness due to an increased risk of local recurrence and EMR may be possible for low-grade dysplasia that is less than 2 cm without surface changes such as redness, depression and nodularity. |
| first_indexed | 2024-12-12T13:52:08Z |
| format | Article |
| id | doaj.art-37f5e12565c14e47800549d2200ba460 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-12T13:52:08Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-37f5e12565c14e47800549d2200ba4602022-12-22T00:22:33ZengBMCBMC Gastroenterology1471-230X2020-05-0120111010.1186/s12876-020-01293-0Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective studyMin Kyung Back0Hee Seok Moon1In Sun Kwon2Jae Ho Park3Ju Seok Kim4Sun Hyung Kang5Jae Kyu Sung6Eaum Seok Lee7Seok Hyun Kim8Byung Seok Lee9Hyun Yong Jeong10Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineClinical Trials Center, Chungnam National University HospitalDivision of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineDivision of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of MedicineAbstract Background Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used techniques for the treatment of gastric epithelial dysplasia. Previous studies have compared the clinical outcome of endoscopic resection for early gastric cancer, but few studies have focused on gastric dysplasia alone. This study aimed to evaluate the long-term prognosis following endoscopic procedures for gastric epithelial dysplasia, investigate differences in local recurrence rates according to the treatment modality, and identify risk factors associated with local recurrence. Methods In this retrospective study, local recurrence rates and risk factors associated with local recurrence were compared between 599 patients who underwent EMR and 306 who underwent ESD for gastric epithelial dysplasia from January 2011 to December 2015. Results The en bloc resection rate (32.2% vs. 100%, p < 0.001) and complete resection rate (94.8% vs. 99.0%, p = 0.003) were significantly lower in the EMR group than in the ESD group. The local recurrence rate was significantly lower in the ESD group (1.3%) than in the EMR group (4.2%; p = 0.026). There was a significantly increased risk of local recurrence, regardless of lesion location or histologic grade, in patients with lesions > 2 cm (p = 0.002) or red in color (p = 0.03). The ESD group had a significantly lower local recurrence rate, with a higher complete resection rate, than that in the EMR group (p < 0.05). In the case of recurrence after endoscopic resection, most of the recurred lesions were removed through additional endoscopic procedures; there was no difference between the two groups (p = 0.153). Conclusions The complete resection rate was significantly higher, and the local recurrence rate was significantly lower, in patients with gastric epithelial dysplasia treated with ESD. Therefore, ESD should be considered the preferred treatment in patients with lesions > 2 cm or showing redness due to an increased risk of local recurrence and EMR may be possible for low-grade dysplasia that is less than 2 cm without surface changes such as redness, depression and nodularity.http://link.springer.com/article/10.1186/s12876-020-01293-0Gastric dysplasiaEndoscopic treatmentLocal recurrenceEndoscopic resection |
| spellingShingle | Min Kyung Back Hee Seok Moon In Sun Kwon Jae Ho Park Ju Seok Kim Sun Hyung Kang Jae Kyu Sung Eaum Seok Lee Seok Hyun Kim Byung Seok Lee Hyun Yong Jeong Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study BMC Gastroenterology Gastric dysplasia Endoscopic treatment Local recurrence Endoscopic resection |
| title | Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study |
| title_full | Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study |
| title_fullStr | Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study |
| title_full_unstemmed | Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study |
| title_short | Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study |
| title_sort | analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia a retrospective study |
| topic | Gastric dysplasia Endoscopic treatment Local recurrence Endoscopic resection |
| url | http://link.springer.com/article/10.1186/s12876-020-01293-0 |
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