한빛사 논문
Ji Yong Ahn MDa, Hwoon-Yong Jung MD, PhD, AGAFa, Kee Don Choi MD, PhDa, Ji Young Choi MDa, Mi-Young Kim MDa, Jeong Hoon Lee MDa, Kwi-Sook Choi MDa, Do Hoon Kim MDa, Ho June Song MD, PhDa, Gin Hyug Lee MD, PhDa, Jin-Ho Kim MD, PhDa, Young Soo Park MD, PhDb
aDepartment of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea
bDepartment of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea
Reprint requests: Hwoon-Yong Jung, MD, PhD, AGAF
Abstract
Background
Current guidelines for endoscopic management such as EMR and endoscopic submucosal dissection (ESD) in early gastric cancer (EGC) are in evolution, with broader indication criteria.
Objective
To determine the clinical outcomes of endoscopic treatment, based on absolute indication and extended indication criteria and endoscopic methods.
Design
Retrospective study.
Setting
Tertiary-care, academic medical center.
Patients
EMR or ESD was performed on 1627 cases of EGC in 1447 patients from July 1994 to January 2009.
Intervention
EMR and ESD.
Main Outcome Measurements
Clinical outcomes of EGC after EMR or ESD, based on the indication criteria.
Results
Although the complete resection rate was higher (95.9% vs 88.4%; P < .001), and the complication rate was lower (6.8% vs 9.8%; P = .054) in the absolute than in the extended indication group, there was no between-group difference in the local recurrence rate (0.9% vs 1.1%; P = .783) at a median follow-up period of 32 months (interquartile range 22-48 months). In the extended indication group, ESD resulted in a significantly higher complete resection rate than EMR (83.0% vs 91.1%; P = .006).
Limitations
Retrospective study.
Conclusion
ESD in the extended indication group showed acceptable clinical outcomes with a relatively high complete resection rate and a low local recurrence rate.
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