Preceding endoscopic submucosal dissection in submucosal invasive gastric cancer patients does not impact clinical outcomes
Abstract Submucosal deep invasion of gastric cancer (T1b2; depth of submucosal invasion ≥ 500 μm) is a risk factor for lymph node metastasis and, thus, is one of the criteria for curative treatment. Our aim was to evaluate the specific influence of endoscopic submucosal dissection (ESD) on the progn...
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| Format: | Article |
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Nature Portfolio
2021-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-020-79696-y |
| _version_ | 1819121072210968576 |
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| author | Kazutaka Kuroki Shiro Oka Shinji Tanaka Naoki Yorita Kosaku Hata Takahiro Kotachi Tomoyuki Boda Koji Arihiro Fumio Shimamoto Kazuaki Chayama |
| author_facet | Kazutaka Kuroki Shiro Oka Shinji Tanaka Naoki Yorita Kosaku Hata Takahiro Kotachi Tomoyuki Boda Koji Arihiro Fumio Shimamoto Kazuaki Chayama |
| author_sort | Kazutaka Kuroki |
| collection | DOAJ |
| description | Abstract Submucosal deep invasion of gastric cancer (T1b2; depth of submucosal invasion ≥ 500 μm) is a risk factor for lymph node metastasis and, thus, is one of the criteria for curative treatment. Our aim was to evaluate the specific influence of endoscopic submucosal dissection (ESD) on the prognosis of patients with T1b2 gastric cancer. This was a retrospective analysis of 248 consecutive patients, with 252 pT1b2 gastric cancer lesions, who underwent ESD prior to additional surgery (Group A, n = 101) or surgery only (Group B, n = 147). After propensity score-matching (for sex, age, tumor diameter and gross type), we compared pathological characteristics between the 2 groups and the prognosis over a follow-up period ≥ 60 months. Compared to Group B, patients in Group A were older, with a higher proportion of men. The proportion of depressed and undifferentiated type tumors was greater in Group B than A, with larger tumor size and depth of submucosal invasion as well. There was no incidence of local recurrence, but distant metastasis was identified in 5% of cases in Group A and 3% in Group B. After propensity score-matching, there were no difference in the 5-year overall survival rate between Group A and B (87.5% vs. 91.2%, respectively), nor in the 5-year disease-specific survival rate (96.3% vs. 96.4%, respectively). ESD prior to surgery for T1b2 gastric cancer did not adversely affect clinical outcomes after additional surgery. |
| first_indexed | 2024-12-22T06:30:44Z |
| format | Article |
| id | doaj.art-86172a74c15e4100b81b8df01e6c950b |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-22T06:30:44Z |
| publishDate | 2021-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-86172a74c15e4100b81b8df01e6c950b2022-12-21T18:35:43ZengNature PortfolioScientific Reports2045-23222021-01-011111910.1038/s41598-020-79696-yPreceding endoscopic submucosal dissection in submucosal invasive gastric cancer patients does not impact clinical outcomesKazutaka Kuroki0Shiro Oka1Shinji Tanaka2Naoki Yorita3Kosaku Hata4Takahiro Kotachi5Tomoyuki Boda6Koji Arihiro7Fumio Shimamoto8Kazuaki Chayama9Department of Gastroenterology and Metabolism, Hiroshima University HospitalDepartment of Gastroenterology and Metabolism, Hiroshima University HospitalDepartment of Endoscopy, Hiroshima University HospitalDepartment of Gastroenterology and Metabolism, Hiroshima University HospitalDepartment of Gastroenterology and Metabolism, Hiroshima University HospitalDepartment of Endoscopy, Hiroshima University HospitalDepartment of Endoscopy, Hiroshima University HospitalDepartment of Anatomical Pathology, Hiroshima University HospitalDepartment of Faculty of Human Culture and Sciences, Hiroshima Shudo UniversityDepartment of Gastroenterology and Metabolism, Hiroshima University HospitalAbstract Submucosal deep invasion of gastric cancer (T1b2; depth of submucosal invasion ≥ 500 μm) is a risk factor for lymph node metastasis and, thus, is one of the criteria for curative treatment. Our aim was to evaluate the specific influence of endoscopic submucosal dissection (ESD) on the prognosis of patients with T1b2 gastric cancer. This was a retrospective analysis of 248 consecutive patients, with 252 pT1b2 gastric cancer lesions, who underwent ESD prior to additional surgery (Group A, n = 101) or surgery only (Group B, n = 147). After propensity score-matching (for sex, age, tumor diameter and gross type), we compared pathological characteristics between the 2 groups and the prognosis over a follow-up period ≥ 60 months. Compared to Group B, patients in Group A were older, with a higher proportion of men. The proportion of depressed and undifferentiated type tumors was greater in Group B than A, with larger tumor size and depth of submucosal invasion as well. There was no incidence of local recurrence, but distant metastasis was identified in 5% of cases in Group A and 3% in Group B. After propensity score-matching, there were no difference in the 5-year overall survival rate between Group A and B (87.5% vs. 91.2%, respectively), nor in the 5-year disease-specific survival rate (96.3% vs. 96.4%, respectively). ESD prior to surgery for T1b2 gastric cancer did not adversely affect clinical outcomes after additional surgery.https://doi.org/10.1038/s41598-020-79696-y |
| spellingShingle | Kazutaka Kuroki Shiro Oka Shinji Tanaka Naoki Yorita Kosaku Hata Takahiro Kotachi Tomoyuki Boda Koji Arihiro Fumio Shimamoto Kazuaki Chayama Preceding endoscopic submucosal dissection in submucosal invasive gastric cancer patients does not impact clinical outcomes Scientific Reports |
| title | Preceding endoscopic submucosal dissection in submucosal invasive gastric cancer patients does not impact clinical outcomes |
| title_full | Preceding endoscopic submucosal dissection in submucosal invasive gastric cancer patients does not impact clinical outcomes |
| title_fullStr | Preceding endoscopic submucosal dissection in submucosal invasive gastric cancer patients does not impact clinical outcomes |
| title_full_unstemmed | Preceding endoscopic submucosal dissection in submucosal invasive gastric cancer patients does not impact clinical outcomes |
| title_short | Preceding endoscopic submucosal dissection in submucosal invasive gastric cancer patients does not impact clinical outcomes |
| title_sort | preceding endoscopic submucosal dissection in submucosal invasive gastric cancer patients does not impact clinical outcomes |
| url | https://doi.org/10.1038/s41598-020-79696-y |
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