Efficacy and safety of endoscopic submucosal dissection for gastric tube cancer: A multicenter retrospective study

被引:4
作者
Satomi, Takuya [1 ]
Kawano, Seiji [1 ]
Inaba, Tomoki [2 ]
Nakagawa, Masahiro [3 ]
Mouri, Hirokazu [4 ]
Yoshioka, Masao [5 ]
Tanaka, Shoichi [6 ]
Toyokawa, Tatsuya [7 ]
Kobayashi, Sayo [8 ]
Tanaka, Takehiro [9 ]
Kanzaki, Hiromitsu [1 ]
Iwamuro, Masaya [1 ]
Kawahara, Yoshiro [10 ]
Okada, Hiroyuki [1 ]
机构
[1] Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci, Okayama, Okayama 7008558, Japan
[2] Kagawa Prefectural Cent Hosp, Dept Gastroenterol, Takamatsu, Kagawa 7608557, Japan
[3] Hiroshima City Hiroshima Citizens Hosp, Dept Endoscopy, Hiroshima, Hiroshima 7308518, Japan
[4] Kurashiki Cent Hosp, Dept Gastroenterol & Hepatol, Kurashiki, Okayama 7108602, Japan
[5] Okayama Saiseikai Gen Hosp, Dept Gastroenterol & Hepatol, Okayama, Okayama 7008511, Japan
[6] Natl Hosp Org Iwakuni Clin Ctr, Dept Gastroenterol, Iwakuni, Yamaguchi 7408510, Japan
[7] Natl Hosp Org Fukuyama Med Ctr, Dept Gastroenterol, Fukuyama, Hiroshima 7208521, Japan
[8] Fukuyama City Hosp, Dept Internal Med, Fukuyama, Hiroshima 7218511, Japan
[9] Okayama Univ Hosp, Dept Pathol, Okayama, Okayama 7008558, Japan
[10] Okayama Univ, Dept Pract Gastrointestinal Endoscopy, Grad Sch Med Dent & Pharmaceut Sci, Okayama, Okayama 7008558, Japan
关键词
Endoscopic submucosal dissection; Gastric tube; Gastric cancer; Eso-phagectomy; Multicenter study; Retrospective study; SQUAMOUS-CELL CANCER; ESOPHAGEAL CANCER; RISK-FACTORS; RESECTION;
D O I
10.3748/wjg.v27.i11.1043
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND Recent improvements in the prognosis of patients with esophageal cancer have led to the increased occurrence of gastric tube cancer (GTC) in the reconstructed gastric tube. However, there are few reports on the treatment results of endoscopic submucosal dissection (ESD) for GTC. AIM To evaluate the efficacy and safety of ESD for GTC after esophagectomy in a multicenter trial. METHODS We retrospectively investigated 48 GTC lesions in 38 consecutive patients with GTC in the reconstructed gastric tube after esophagectomy who had undergone ESD between January 2005 and December 2019 at 8 institutions participating in the Okayama Gut Study group. The clinical indications of ESD for early gastric cancer were similarly applied for GTC after esophagectomy. ESD specimens were evaluated in 2-mm slices according to the Japanese Classification of Gastric Carcinoma with curability assessments divided into curative and non-curative resection based on the Gastric Cancer Treatment Guidelines. Patient characteristics, treatment results, clinical course, and treatment outcomes were analyzed. RESULTS The median age of patients was 71.5 years (range, 57-84years), and there were 34 men and 4 women. The median observation period after ESD was 884 d (range, 8-4040 d). The median procedure time was 81 min (range, 29-334 min), the en bloc resection rate was 91.7% (44/48), and the curative resection rate was 79% (38/48). Complications during ESD were seen in 4% (2/48) of case, and those after ESD were seen in 10% (5/48) of case. The survival rate at 5 years was 59.5%. During the observation period after ESD, 10 patients died of other diseases. Although there were differences in the procedure time between institutions, a multivariate analysis showed that tumor size was the only factor associated with prolonged procedure time. CONCLUSION ESD for GTC after esophagectomy was shown to be safe and effective.
引用
收藏
页码:1043 / 1054
页数:12
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