Outcomes of endoscopic submucosal dissection for early gastric cancer and precancer lesion: Experience from a center in Southern Taiwan

Background: Limited data are available on the interval of disease-free status after endoscopic submucosal dissection (ESD) for early gastric cancer and precancer lesion in Taiwan. In this long-term (2-105 months) follow-up study, we analyzed the risk factors that affect the local recurrence and noncurative resection (non-CR) of these lesions. Methods: We retrospectively studied 65 consecutive treatment-naive patients with 69 EGC lesions who were selected to be treated by ESD. A total of 56 lesions (48 CR lesions and 8 non-CR lesions) were analyzed for local recurrence after ESD. Results and Discussion: ESD was curative for gastric epithelial tumors in 51 (73.9%) but not in 18 (26.1%) lesions. Unfortunately, five (8.93%) of these 56 lesions in 53 patients had local recurrence. None of the patients died from gastric cancer-associated diseases during follow-up. In our studies, the cumulative local recurrence rates were 5.3% in the CR group and 56.7% in the non-CR group (p = 0.0091). The disease-free status was high (94.7%) with CR. The risk factors that affect the non-CR were tumor location (p = 0.013), deeper invasion (p < 0.001), undifferentiated histopathology (p < 0.001), and ulcer presence (p = 0.045). Conclusion: ESD offers good outcome after treatment for EGC. To decrease the risk of local recurrence, preoperative diagnosis of tumor extent and accurate postoperative pathological evaluation are very important. Copyright (C) 2015, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver. Published by Elsevier Taiwan LLC. All rights reserved.