Endoscopic submucosal dissection for submucosal invasive gastric cancer and curability criteria

Shu Hoteya, Toshiro Iizuka, Satoshi Yamashita, Daisuke Kikuchi, Masanori Nakamura, Kaoru Domon, Akira Matsui, Toshihumi Mitani, Osamu Ogawa, Mitsuru Kaise, Naohisa Yahagi

Research output: Contribution to journalArticle

Abstract

Aims : The aims of the present study were to evaluate the feasibility of endoscopic submucosal dissection (ESD) as curative treatment for node-negative submucosal invasive early gastric cancer (EGC) and to consider further expansion of the curability criteria for submucosal invasive EGC. Methods : A total of 977 EGC in 855 patients treated by ESD were enrolled. They were divided into intramucosal cancer (M) ; minimally submucosal invasive cancer (<500μ from the muscularis mucosa) (SM1) ; and deeper submucosal invasive cancer (>500μm from the muscularis mucosa) (SM2). The technical feasibility of ESD for SM1 and M were compared, and the clinical prognosis of SM1 was evaluated. Furthermore, the volume of carcinoma invading to the submucosal layer, which we called the SM volume index, was calculated virtually to analyze its correlation with lymphatic-vascular invasion. Results : There were no statistical differences in technical outcomes and complications between M and SM1. Curative resection rates were significantly better in M than in SMl (M, 92.6% : SM1, 63.8%). No local recurrences and distant metastases were found in 48 SM1 patients declared to have undergone curative resections. Most cases (72.0%) with successful ESD but non-- curative resection exceeded 30 mm in maximum size, and no local recurrences and metastases were found in these patients. The SM volume index of these cases was comparatively small. Conclusion : The technical and theoretical validity of ESD for SM1 was validated. The possibility of further expansion of the curability criteria for submucosal invasive cancers was suggested by the evaluation of the SM volume index.

Original languageEnglish
Pages (from-to)3446-3454
Number of pages9
JournalGastroenterological Endoscopy
Volume54
Issue number10
Publication statusPublished - 2012 Oct

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Stomach Neoplasms
Neoplasm Metastasis
Recurrence
Neoplasms
Blood Vessels
Mucous Membrane
Endoscopic Mucosal Resection
Carcinoma
Therapeutics

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

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Hoteya, S., Iizuka, T., Yamashita, S., Kikuchi, D., Nakamura, M., Domon, K., ... Yahagi, N. (2012). Endoscopic submucosal dissection for submucosal invasive gastric cancer and curability criteria. Gastroenterological Endoscopy, 54(10), 3446-3454.

Endoscopic submucosal dissection for submucosal invasive gastric cancer and curability criteria. / Hoteya, Shu; Iizuka, Toshiro; Yamashita, Satoshi; Kikuchi, Daisuke; Nakamura, Masanori; Domon, Kaoru; Matsui, Akira; Mitani, Toshihumi; Ogawa, Osamu; Kaise, Mitsuru; Yahagi, Naohisa.

In: Gastroenterological Endoscopy, Vol. 54, No. 10, 10.2012, p. 3446-3454.

Research output: Contribution to journalArticle

Hoteya, S, Iizuka, T, Yamashita, S, Kikuchi, D, Nakamura, M, Domon, K, Matsui, A, Mitani, T, Ogawa, O, Kaise, M & Yahagi, N 2012, 'Endoscopic submucosal dissection for submucosal invasive gastric cancer and curability criteria', Gastroenterological Endoscopy, vol. 54, no. 10, pp. 3446-3454.
Hoteya S, Iizuka T, Yamashita S, Kikuchi D, Nakamura M, Domon K et al. Endoscopic submucosal dissection for submucosal invasive gastric cancer and curability criteria. Gastroenterological Endoscopy. 2012 Oct;54(10):3446-3454.
Hoteya, Shu ; Iizuka, Toshiro ; Yamashita, Satoshi ; Kikuchi, Daisuke ; Nakamura, Masanori ; Domon, Kaoru ; Matsui, Akira ; Mitani, Toshihumi ; Ogawa, Osamu ; Kaise, Mitsuru ; Yahagi, Naohisa. / Endoscopic submucosal dissection for submucosal invasive gastric cancer and curability criteria. In: Gastroenterological Endoscopy. 2012 ; Vol. 54, No. 10. pp. 3446-3454.
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AU - Nakamura, Masanori

AU - Domon, Kaoru

AU - Matsui, Akira

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