Short-term outcomes of multicenter prospective cohort study of gastric endoscopic resection: 'Real-world evidence' in Japan

被引：141

作者：

Suzuki, Haruhisa ^{[1
]}

Takizawa, Kohei ^{[6
]}

Hirasawa, Toshiaki ^{[2
]}

Takeuchi, Yoji ^{[7
]}

Ishido, Kenji ^{[8
]}

Hoteya, Shu ^{[3
]}

Yano, Tomonori ^{[10
]}

Tanaka, Shinji ^{[11
]}

Endo, Masaki ^{[14
]}

Nakagawa, Masahiro ^{[12
]}

Toyonaga, Takashi ^{[15
]}

Doyama, Hisashi ^{[16
]}

Hirasawa, Kingo ^{[17
]}

Matsuda, Mitsuru ^{[18
]}

Yamamoto, Hironori ^{[19
]}

Fujishiro, Mitsuhiro ^{[4
]}

Hashimoto, Satoru ^{[20
]}

Maeda, Yuki ^{[21
]}

Oyama, Tsuneo ^{[22
]}

Takenaka, Ryuta ^{[23
]}

Yamamoto, Yoshinobu ^{[24
]}

Naito, Yuji ^{[25
]}

Michida, Tomoki ^{[26
]}

Kobayashi, Nozomu ^{[27
]}

Kawahara, Yoshiro ^{[28
]}

Hirano, Masaaki ^{[29
]}

Jin, Mario ^{[30
]}

Hori, Shinichiro ^{[31
]}

Niwa, Yasumasa ^{[32
]}

Hikichi, Takuto ^{[33
]}

Shimazu, Taichi ^{[5
]}

Ono, Hiroyuki ^{[6
]}

Tanabe, Satoshi ^{[9
]}

Kondo, Hitoshi ^{[34
]}

Iishi, Hiroyasu ^{[7
]}

Ninomiya, Motoki ^{[13
]}

Oda, Ichiro ^{[1
]}

机构：

[1] Natl Canc Ctr, Endoscopy Div, Tokyo, Japan

[2] Canc Inst Hosp, Dept Gastroenterol, Tokyo, Japan

[3] Toranomon Gen Hosp, Dept Gastroenterol, Tokyo, Japan

[4] Univ Tokyo, Grad Sch Med, Dept Endoscopy & Endoscop Surg, Tokyo, Japan

[5] Natl Canc Ctr, Ctr Publ Hlth Sci, Epidemiol & Prevent Grp, Tokyo, Japan

[6] Shizuoka Canc Ctr, Div Endoscopy, Nagaizumi, Osaka, Japan

[7] Osaka Int Canc Inst, Dept Gastrointestinal Oncol, Osaka, Japan

[8] Kitasato Univ, Sch Med, Dept Gastroenterol, Sagamihara, Kanagawa, Japan

[9] Kitasato Univ, Dept Adv Med, Res & Dev Ctr New Med Frontiers, Sagamihara, Kanagawa, Japan

[10] Natl Canc Ctr Hosp East, Dept Gastroenterol & Endoscopy, Kashiwa, Chiba, Japan

[11] Hiroshima Univ Hosp, Dept Endoscopy, Hiroshima, Japan

[12] Hiroshima City Hosp, Dept Endoscopy, Hiroshima, Japan

[13] Hiroshima Mem Hosp, Ctr Digest Dis, Hiroshima, Japan

[14] Iwate Med Univ, Sch Med, Div Gastroenterol, Dept Internal Med, Morioka, Iwate, Japan

[15] Kobe Univ Hosp, Dept Endoscopy, Kobe, Hyogo, Japan

[16] Ishikawa Prefectural Cent Hosp, Dept Gastroenterol, Kanazawa, Ishikawa, Japan

[17] Yokohama City Univ, Med Ctr, Div Endoscopy, Yokohama, Kanagawa, Japan

[18] Toyama Prefectural Cent Hosp, Dept Internal Med, Toyama, Japan

[19] Jichi Med Univ, Div Gastroenterol, Dept Internal Med, Shimotsuke, Japan

[20] Niigata Univ, Med & Dent Hosp, Div Gastroenterol & Hepatol, Niigata, Japan

[21] Sendai Kousei Hosp, Dept Gastroenterol, Sendai, Miyagi, Japan

[22] Saku Cent Hosp Adv Care Ctr, Dept Endoscopy, Saku, Nagano, Japan

[23] Tsuyama Chuo Hosp, Dept Gastroenterol, Tsuyama, Japan

[24] Hyogo Canc Ctr, Dept Gastroenterol Oncol, Akashi, Hyogo, Japan

[25] Kyoto Prefectural Univ Med, Dept Mol Gastroenterol & Hepatol, Kyoto, Japan

[26] Saitama Med Univ, Saitama Med Ctr, Dept Gastroenterol & Hepatol, Kawagoe, Saitama, Japan

[27] Tochigi Canc Ctr, Dept Gastroenterol, Utsunomiya, Tochigi, Japan

[28] Okayama Univ Hosp, Dept Endoscopy, Okayama, Japan

[29] Niigata Prefectural Cent Hosp, Dept Internal Med, Joetsu, Japan

[30] Akita Univ, Grad Sch Med, Dept Gastroenterol, Akita, Japan

[31] Natl Hosp Org Shikoku Canc Ctr, Dept Gastroenterol, Matsuyama, Ehime, Japan

[32] Aichi Canc Ctr Hosp, Dept Endoscopy, Nagoya, Aichi, Japan

[33] Fukushima Med Univ Hosp, Dept Endoscopy, Fukushima, Japan

[34] Tonan Hosp, Ctr Digest Dis, Sapporo, Hokkaido, Japan

来源：

DIGESTIVE ENDOSCOPY | 2019年 / 31卷 / 01期

基金：

日本学术振兴会;

关键词：

early gastric cancer; endoscopic resection; multicenter prospective study; real-world evidence; short-term outcome; LYMPH-NODE METASTASIS; SUBMUCOSAL DISSECTION; CLINICAL-OUTCOMES; RISK-FACTORS; CANCER; ABSOLUTE; PREDICT; TIME;

D O I：

10.1111/den.13246

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives A Japanese multicenter prospective cohort study examining endoscopic resection (ER) for early gastric cancer (EGC) has been conducted using a Web registry developed to determine the short-term and long-term outcomes based on absolute and expanded indications. We hereby present the short-term outcomes of this study. Methods All consecutive patients with EGC or suspected EGC undergoing ER at 41 participating institutions between July 2010 and June 2012 were enrolled and prospectively registered into the Web registry. The baseline characteristics were entered before ER, and the short-term outcomes were collected at 6 months following ER. Results Nine thousand six hundred and sixteen patients with 10 821 lesions underwent ER (endoscopic submucosal dissection [ESD]: 99.4%). The median procedure time was 76 min, and R0 resections were achieved for 91.6% of the lesions. Postoperative bleeding and intraoperative perforation occurred in 4.4% and 2.3% of the patients, respectively. Significant independent factors correlated with a longer procedure time (120 min or longer) were as follows: tumor size >20 mm, upper-third location, middle-third location, local recurrent lesion, ulcer findings, gastric tube, male gender, and submucosa. Histopathologically, 10 031 lesions were identified as common-type gastric cancers. The median tumor size was 15 mm. Noncurative resections were diagnosed for 18.3% of the lesions. Additional surgery was performed for 48.6% (824 lesions) of the 1695 noncurative ER lesions with a possible risk of lymph node (LN) metastasis. Among them, 64 (7.8%) exhibited LN metastasis. Conclusions This multicenter prospective study showed favorable short-term outcomes for gastric ESD.

引用

页码：30 / 39

页数：10

共 37 条

[1] Endoscopic and oncologic outcomes after endoscopic resection for early gastric cancer: 1370 cases of absolute and extended indications [J].