Outcomes of ESD for patients with early gastric cancer and comorbid liver cirrhosis

a propensity score analysis

Motohiko Kato, Tsutomu Nishida, Toshimitsu Hamasaki, Naoki Kawai, Toshiyuki Yoshio, Satoshi Egawa, Katsumi Yamamoto, Hideharu Ogiyama, Masato Komori, Masanori Nakahara, Takamasa Yabuta, Akihiro Nishihara, Yoshito Hayashi, Takuya Yamada, Tetsuo Takehara

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Gastric cancer and liver cirrhosis (LC) are often comorbid. However, little is known about the clinical outcomes of gastric endoscopic submucosal dissection (ESD) in patients with comorbid LC. Methods: This case–control study used a multicentre retrospective cohort. We identified 69 LC patients from the cohort of patients with early gastric cancer, who underwent gastric ESD at 12 hospitals from March 2003 to November 2010. Using the propensity score matching method, 69 patients without LC were used to compare the short- and long-term outcomes of ESD. Results: Among the 69 LC patients, 53 (77 %) were Child-Pugh grade A (CP-A) and 16 (28 %) had past or present histories of hepatocellular carcinoma (HCC). Short-term outcomes did not differ between the LC patients and controls or between the CP-A and CP-B/C patients. Although the LC patients had significantly worse long-term outcomes than the controls (the 5-year overall survival rates were 60 vs. 91 %, respectively), patients with CP-A liver function without HCC histories had an overall survival almost equivalent to that of patients without LC (controls). Conclusions: LC patients appear to be good candidates for ESD if they have CP-A liver function and no history of HCC. Although their short-term outcomes were not inferior, the patients with Child-Pugh grades B/C or with histories of HCC benefited less from ESD.

Original languageEnglish
Pages (from-to)1560-1566
Number of pages7
JournalSurgical Endoscopy and Other Interventional Techniques
Volume29
Issue number6
DOIs
Publication statusPublished - 2015 Jun 1
Externally publishedYes

Fingerprint

Propensity Score
Liver Neoplasms
Liver Cirrhosis
Stomach Neoplasms
Hepatocellular Carcinoma
Endoscopic Mucosal Resection
Stomach
Liver
Survival Rate

Keywords

  • ESD
  • Liver cirrhosis
  • Outcomes

ASJC Scopus subject areas

  • Surgery

Cite this

Outcomes of ESD for patients with early gastric cancer and comorbid liver cirrhosis : a propensity score analysis. / Kato, Motohiko; Nishida, Tsutomu; Hamasaki, Toshimitsu; Kawai, Naoki; Yoshio, Toshiyuki; Egawa, Satoshi; Yamamoto, Katsumi; Ogiyama, Hideharu; Komori, Masato; Nakahara, Masanori; Yabuta, Takamasa; Nishihara, Akihiro; Hayashi, Yoshito; Yamada, Takuya; Takehara, Tetsuo.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 29, No. 6, 01.06.2015, p. 1560-1566.

Research output: Contribution to journalArticle

Kato, M, Nishida, T, Hamasaki, T, Kawai, N, Yoshio, T, Egawa, S, Yamamoto, K, Ogiyama, H, Komori, M, Nakahara, M, Yabuta, T, Nishihara, A, Hayashi, Y, Yamada, T & Takehara, T 2015, 'Outcomes of ESD for patients with early gastric cancer and comorbid liver cirrhosis: a propensity score analysis', Surgical Endoscopy and Other Interventional Techniques, vol. 29, no. 6, pp. 1560-1566. https://doi.org/10.1007/s00464-014-3841-y
Kato, Motohiko ; Nishida, Tsutomu ; Hamasaki, Toshimitsu ; Kawai, Naoki ; Yoshio, Toshiyuki ; Egawa, Satoshi ; Yamamoto, Katsumi ; Ogiyama, Hideharu ; Komori, Masato ; Nakahara, Masanori ; Yabuta, Takamasa ; Nishihara, Akihiro ; Hayashi, Yoshito ; Yamada, Takuya ; Takehara, Tetsuo. / Outcomes of ESD for patients with early gastric cancer and comorbid liver cirrhosis : a propensity score analysis. In: Surgical Endoscopy and Other Interventional Techniques. 2015 ; Vol. 29, No. 6. pp. 1560-1566.
@article{310c92d23a164f08894bdddcb9efaca7,
title = "Outcomes of ESD for patients with early gastric cancer and comorbid liver cirrhosis: a propensity score analysis",
abstract = "Background: Gastric cancer and liver cirrhosis (LC) are often comorbid. However, little is known about the clinical outcomes of gastric endoscopic submucosal dissection (ESD) in patients with comorbid LC. Methods: This case–control study used a multicentre retrospective cohort. We identified 69 LC patients from the cohort of patients with early gastric cancer, who underwent gastric ESD at 12 hospitals from March 2003 to November 2010. Using the propensity score matching method, 69 patients without LC were used to compare the short- and long-term outcomes of ESD. Results: Among the 69 LC patients, 53 (77 {\%}) were Child-Pugh grade A (CP-A) and 16 (28 {\%}) had past or present histories of hepatocellular carcinoma (HCC). Short-term outcomes did not differ between the LC patients and controls or between the CP-A and CP-B/C patients. Although the LC patients had significantly worse long-term outcomes than the controls (the 5-year overall survival rates were 60 vs. 91 {\%}, respectively), patients with CP-A liver function without HCC histories had an overall survival almost equivalent to that of patients without LC (controls). Conclusions: LC patients appear to be good candidates for ESD if they have CP-A liver function and no history of HCC. Although their short-term outcomes were not inferior, the patients with Child-Pugh grades B/C or with histories of HCC benefited less from ESD.",
keywords = "ESD, Liver cirrhosis, Outcomes",
author = "Motohiko Kato and Tsutomu Nishida and Toshimitsu Hamasaki and Naoki Kawai and Toshiyuki Yoshio and Satoshi Egawa and Katsumi Yamamoto and Hideharu Ogiyama and Masato Komori and Masanori Nakahara and Takamasa Yabuta and Akihiro Nishihara and Yoshito Hayashi and Takuya Yamada and Tetsuo Takehara",
year = "2015",
month = "6",
day = "1",
doi = "10.1007/s00464-014-3841-y",
language = "English",
volume = "29",
pages = "1560--1566",
journal = "Surgical Endoscopy and Other Interventional Techniques",
issn = "0930-2794",
publisher = "Springer New York",
number = "6",

}

TY - JOUR

T1 - Outcomes of ESD for patients with early gastric cancer and comorbid liver cirrhosis

T2 - a propensity score analysis

AU - Kato, Motohiko

AU - Nishida, Tsutomu

AU - Hamasaki, Toshimitsu

AU - Kawai, Naoki

AU - Yoshio, Toshiyuki

AU - Egawa, Satoshi

AU - Yamamoto, Katsumi

AU - Ogiyama, Hideharu

AU - Komori, Masato

AU - Nakahara, Masanori

AU - Yabuta, Takamasa

AU - Nishihara, Akihiro

AU - Hayashi, Yoshito

AU - Yamada, Takuya

AU - Takehara, Tetsuo

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background: Gastric cancer and liver cirrhosis (LC) are often comorbid. However, little is known about the clinical outcomes of gastric endoscopic submucosal dissection (ESD) in patients with comorbid LC. Methods: This case–control study used a multicentre retrospective cohort. We identified 69 LC patients from the cohort of patients with early gastric cancer, who underwent gastric ESD at 12 hospitals from March 2003 to November 2010. Using the propensity score matching method, 69 patients without LC were used to compare the short- and long-term outcomes of ESD. Results: Among the 69 LC patients, 53 (77 %) were Child-Pugh grade A (CP-A) and 16 (28 %) had past or present histories of hepatocellular carcinoma (HCC). Short-term outcomes did not differ between the LC patients and controls or between the CP-A and CP-B/C patients. Although the LC patients had significantly worse long-term outcomes than the controls (the 5-year overall survival rates were 60 vs. 91 %, respectively), patients with CP-A liver function without HCC histories had an overall survival almost equivalent to that of patients without LC (controls). Conclusions: LC patients appear to be good candidates for ESD if they have CP-A liver function and no history of HCC. Although their short-term outcomes were not inferior, the patients with Child-Pugh grades B/C or with histories of HCC benefited less from ESD.

AB - Background: Gastric cancer and liver cirrhosis (LC) are often comorbid. However, little is known about the clinical outcomes of gastric endoscopic submucosal dissection (ESD) in patients with comorbid LC. Methods: This case–control study used a multicentre retrospective cohort. We identified 69 LC patients from the cohort of patients with early gastric cancer, who underwent gastric ESD at 12 hospitals from March 2003 to November 2010. Using the propensity score matching method, 69 patients without LC were used to compare the short- and long-term outcomes of ESD. Results: Among the 69 LC patients, 53 (77 %) were Child-Pugh grade A (CP-A) and 16 (28 %) had past or present histories of hepatocellular carcinoma (HCC). Short-term outcomes did not differ between the LC patients and controls or between the CP-A and CP-B/C patients. Although the LC patients had significantly worse long-term outcomes than the controls (the 5-year overall survival rates were 60 vs. 91 %, respectively), patients with CP-A liver function without HCC histories had an overall survival almost equivalent to that of patients without LC (controls). Conclusions: LC patients appear to be good candidates for ESD if they have CP-A liver function and no history of HCC. Although their short-term outcomes were not inferior, the patients with Child-Pugh grades B/C or with histories of HCC benefited less from ESD.

KW - ESD

KW - Liver cirrhosis

KW - Outcomes

UR - http://www.scopus.com/inward/record.url?scp=84928902254&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928902254&partnerID=8YFLogxK

U2 - 10.1007/s00464-014-3841-y

DO - 10.1007/s00464-014-3841-y

M3 - Article

VL - 29

SP - 1560

EP - 1566

JO - Surgical Endoscopy and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

SN - 0930-2794

IS - 6

ER -