Evaluating the Need for Additional Surgery After Non-Curative Endoscopic Resection in Patients with Remnant Gastric Cancer

被引：0

作者：

Minamide, Tatsunori ^{[1
]}

Ono, Hiroyuki ^{[1
]}

Kawata, Noboru ^{[1
]}

Maeda, Yuki ^{[1
]}

Yoshida, Masao ^{[1
]}

Yamamoto, Yoichi ^{[1
]}

Takada, Kazunori ^{[1
]}

Kishida, Yoshihiro ^{[1
]}

Ito, Sayo ^{[1
]}

Imai, Kenichiro ^{[1
]}

Hotta, Kinichi ^{[1
]}

Sato, Junya ^{[1
]}

Ishiwatari, Hirotoshi ^{[1
]}

Matsubayashi, Hiroyuki ^{[1
]}

Notsu, Akifumi ^{[2
]}

Bando, Etsuro ^{[3
]}

机构：

[1] Shizuoka Canc Ctr, Div Endoscopy, Nagaizumi, Shizuoka 4118777, Japan

[2] Shizuoka Canc Ctr, Clin Res Ctr, Nagaizumi, Shizuoka 4118777, Japan

[3] Shizuoka Canc Ctr, Div Gastr Surg, Nagaizumi, Shizuoka 4118777, Japan

来源：

JOURNAL OF GASTROINTESTINAL CANCER | 2025年 / 56卷 / 01期

关键词：

Endoscopic submucosal dissection; Gastrectomy; Gastric cancer; Lymph node metastasis; Survival; SUBMUCOSAL DISSECTION; RADICAL SURGERY; OUTCOMES; STOMACH;

D O I：

10.1007/s12029-025-01199-8

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose Completion total gastrectomy is considered an additional treatment after non-curative endoscopic resection for remnant gastric cancer. However, its high invasiveness remains a concern. This study aimed to assess the necessity of additional surgery after non-curative endoscopic submucosal dissection in patients with remnant gastric cancer. Methods This study included patients who underwent non-curative endoscopic submucosal dissection for remnant gastric cancer between September 2002 and January 2018. The eCura system was used to stratify the risk of lymph node metastasis into low, intermediate, or high. The overall survival, disease-specific survival, and long-term clinical course were analyzed. Results Among the 46 patients analyzed, 15 underwent additional completion total gastrectomy, whereas 31 were only followed up. Within a median follow-up period of 62.5 months, the additional surgery and follow-up groups showed 5-year overall survival rates of 79.4% and 76.8% (P = 0.93) and disease-specific survival rates of 92.9% and 92.7% (P = 0.98). A total of 19 low-, 8 intermediate-, and 4 high-risk patients in the follow-up group achieved 5-year disease-specific survival rates of 100%, 100%, and 33.3%. Significant differences were observed in the disease-specific survival between the low- and high-risk patients (P < 0.001) and between the intermediate- and high-risk patients (P = 0.02). Conclusion Risk stratification using the eCura system allows for individualized treatment decisions, with follow-up being a viable option for low- and intermediate-risk patients and additional surgery recommended for high-risk patients after non-curative endoscopic submucosal dissection for remnant gastric cancer.

引用

页数：11

共 22 条

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