Feasibility of Endoscopic Submucosal Dissection for Submucosal-invasive Gastric Cancer and the Predictors of Residual or Recurrent Cancer

Purpose of the Study:The purpose of this study was to determine the feasibility of the endoscopic submucosal dissection (ESD) for submucosal-invasive gastric cancer (SMGC) by assessing the therapeutic outcomes in patients treated with ESD.Materials and Methods:From 2002 to 2013, ESD was performed for 597 lesions with early gastric cancer at our institute. ESD of the SMGC was performed for 85 patients.Results:Among these 85 patients, 35 patients underwent additional gastrectomy. Residual or recurrent cancer occurred in 12 patients treated through ESD method. The 5-year disease-specific survival rates were 94.9% for all 85 patients and 97.2% for 49 patients with follow-up examinations after ESD. The multivariate logistic regression analysis indicated that residual or recurrent cancer in the patients with SMGC was significantly associated with a tumor width in submucosa (P=0.0152).Conclusions:ESD for SMGC can be considered feasible in clinical practice in terms of the favorable long-term oncologic outcomes.