Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer
Endoscopic submucosal dissection (ESD) is considered the treatment of choice for early gastric cancer (EGC) with a negligible risk of lymph node metastasis. Locally recurrent lesions on artificial ulcer scars are difficult to manage. Predicting the risk of local recurrence after ESD is important to...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/2018 |
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| author | Dae-Gon Ryu Su-Jin Kim Cheol-Woong Choi Su-Bum Park Hyeong-Seok Nam Si-Hak Lee Sun-Hwi Hwang |
| author_facet | Dae-Gon Ryu Su-Jin Kim Cheol-Woong Choi Su-Bum Park Hyeong-Seok Nam Si-Hak Lee Sun-Hwi Hwang |
| author_sort | Dae-Gon Ryu |
| collection | DOAJ |
| description | Endoscopic submucosal dissection (ESD) is considered the treatment of choice for early gastric cancer (EGC) with a negligible risk of lymph node metastasis. Locally recurrent lesions on artificial ulcer scars are difficult to manage. Predicting the risk of local recurrence after ESD is important to manage and prevent the event. We aimed to elucidate the risk factors associated with local recurrence after ESD of EGC. Between November 2008 and February 2016, consecutive patients (n = 641; mean age, 69.3 ± 9.5 years; men, 77.2%) with EGC who underwent ESD at a single tertiary referral hospital were retrospectively analyzed to evaluate the incidence and factors associated with local recurrence. Local recurrence was defined as the development of neoplastic lesions at or adjacent to the site of the post-ESD scar. En bloc and complete resection rates were 97.8% and 93.6%, respectively. The local recurrence rate after ESD was 3.1%. The mean follow-up period after ESD was 50.7 ± 32.5 months. One case of gastric cancer-related death (0.15%) was noted, wherein the patient had refused additive surgical resection after ESD for EGC with lymphatic and deep submucosal invasion. Lesion size ≥15 mm, incomplete histologic resection, undifferentiated adenocarcinoma, scar, and the absence of erythema of the surface were associated with a higher risk of local recurrence. Predicting local recurrence during regular endoscopic surveillance after ESD is important, especially in patients with a larger lesion size (≥15 mm), incomplete histologic resection, surface changes of scars, and no erythema of the surface. |
| first_indexed | 2024-03-11T07:19:27Z |
| format | Article |
| id | doaj.art-4008168e62a34a55ae29a0d41dd7a024 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:19:27Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4008168e62a34a55ae29a0d41dd7a0242023-11-17T08:01:29ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01125201810.3390/jcm12052018Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric CancerDae-Gon Ryu0Su-Jin Kim1Cheol-Woong Choi2Su-Bum Park3Hyeong-Seok Nam4Si-Hak Lee5Sun-Hwi Hwang6Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of KoreaDepartment of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of KoreaDepartment of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of KoreaDepartment of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of KoreaDepartment of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of KoreaDepartment of Surgery, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of KoreaDepartment of Surgery, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of KoreaEndoscopic submucosal dissection (ESD) is considered the treatment of choice for early gastric cancer (EGC) with a negligible risk of lymph node metastasis. Locally recurrent lesions on artificial ulcer scars are difficult to manage. Predicting the risk of local recurrence after ESD is important to manage and prevent the event. We aimed to elucidate the risk factors associated with local recurrence after ESD of EGC. Between November 2008 and February 2016, consecutive patients (n = 641; mean age, 69.3 ± 9.5 years; men, 77.2%) with EGC who underwent ESD at a single tertiary referral hospital were retrospectively analyzed to evaluate the incidence and factors associated with local recurrence. Local recurrence was defined as the development of neoplastic lesions at or adjacent to the site of the post-ESD scar. En bloc and complete resection rates were 97.8% and 93.6%, respectively. The local recurrence rate after ESD was 3.1%. The mean follow-up period after ESD was 50.7 ± 32.5 months. One case of gastric cancer-related death (0.15%) was noted, wherein the patient had refused additive surgical resection after ESD for EGC with lymphatic and deep submucosal invasion. Lesion size ≥15 mm, incomplete histologic resection, undifferentiated adenocarcinoma, scar, and the absence of erythema of the surface were associated with a higher risk of local recurrence. Predicting local recurrence during regular endoscopic surveillance after ESD is important, especially in patients with a larger lesion size (≥15 mm), incomplete histologic resection, surface changes of scars, and no erythema of the surface.https://www.mdpi.com/2077-0383/12/5/2018early gastric cancerendoscopic submucosal dissectionrecurrencescar |
| spellingShingle | Dae-Gon Ryu Su-Jin Kim Cheol-Woong Choi Su-Bum Park Hyeong-Seok Nam Si-Hak Lee Sun-Hwi Hwang Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer Journal of Clinical Medicine early gastric cancer endoscopic submucosal dissection recurrence scar |
| title | Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer |
| title_full | Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer |
| title_fullStr | Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer |
| title_full_unstemmed | Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer |
| title_short | Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer |
| title_sort | local recurrence after endoscopic submucosal dissection of early gastric cancer |
| topic | early gastric cancer endoscopic submucosal dissection recurrence scar |
| url | https://www.mdpi.com/2077-0383/12/5/2018 |
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