Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center.
In: Clinics (Sao Paulo, Brazil), Jg. 73 (2018-10-11), Heft supp 1, S. e553s
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Zugriff:
Objective: Our aim was to evaluate the Japan Gastroenterological Endoscopy Society criteria for endoscopic submucosal resection of early gastric cancer (EGC) based on the experience in a Brazilian cancer center.
Methods: We included all patients who underwent endoscopic submucosal resection for gastric lesions between February 2009 and October 2016. Demographic data and information regarding the endoscopic resection, pathological report and follow-up were obtained. Statistical calculations were performed with Fisher's exact test and chi-square tests, with 95% confidence intervals.
Results: In total, 76% of the 51 lesions were adenocarcinomas, 16% were adenomas, and 8% had other diagnoses. The average size was 19.9 mm (±11.7). The average procedure length was 113.9 minutes (±71.4). The complication rate was 21.3%, with only one patient who needed surgical treatment (transmural perforation). Among the adenocarcinomas, 39.5% met the classic criteria for curability, 31.6% met the expanded criteria and 28.9% met the criteria for noncurative resection. Analysis of the indication criteria and curability revealed differences among cases with "only-by-size" expanded criteria (64.28%), other expanded criteria (40%) and classic criteria (89.47%), with a p-value of 0.049. During follow-up (15.8 months; ±14.3), 86.1% of the EGC patients had no recurrence. When well-differentiated and poorly differentiated lesions or lesions included in the classic and expanded criteria were compared, there were no differences in recurrence. The noncurative group presented a higher recurrence rate than the classic group (p=0.014).
Conclusion: These results suggest that the Japanese endoscopic submucosal resection criteria might be useful for endoscopic treatment of EGC in Western countries.
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Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center.
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Autor/in / Beteiligte Person: | Mendonça, EQ ; Pessorrusso, FCS ; Ramos, MFKP ; Jacob, CE ; Oliveira, JF ; Ribeiro, MS ; Safatle-Ribeiro, A ; Zilberstein, B ; Ribeiro Júnior, U ; Maluf-Filho, F |
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Zeitschrift: | Clinics (Sao Paulo, Brazil), Jg. 73 (2018-10-11), Heft supp 1, S. e553s |
Veröffentlichung: | 2022- : [New York] : Elsevier ; <i>Original Publication</i>: São Paulo, SP : Hospital das Clínicas, Faculty of Medicine, University of São Paulo, [2005]-, 2018 |
Medientyp: | academicJournal |
ISSN: | 1980-5322 (electronic) |
DOI: | 10.6061/clinics/2018/e553s |
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