https://scholars.lib.ntu.edu.tw/handle/123456789/516203
標題: | Endoscopic submucosal dissection comparing with surgical resection in patients with early gastric cancer – A single center experience in Taiwan | 作者: | TZU-CHAN HONG JYH-MING LIOU CHI-CHUAN YEH HUNG-HSUAN YEN MING-SHIANG WU I-RUE LAI CHIEN-CHUAN CHEN |
公開日期: | 2020 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: The choice of endoscopic submucosal dissection (ESD) as first line treatment for selected early gastric cancer (EGC) patients was proved as effective as surgical treatment in studies over many countries. Yet there is no such cohort comparison in Taiwan. This study is aimed to describe our experience in ESD treated EGC and to compare the outcomes with those underwent surgical treatment. Methods: This was a retrospective cohort study reviewing the patients with EGC underwent ESD and surgical treatments in a single tertiary referral center in Taiwan. The primary endpoint was disease specific survival. Recurrence free survival and length of hospital stay were also compared. Results: The disease specific survival between indicated ESD and surgery showed no significant difference (cumulative survival 100% vs. 97.03%, p = 0.39), so as the recurrence free survival (cumulative survival 92.31% vs. 94.06%, p = 0.60). In subgroup analyses of ESD treated patients, a non-significant recurrence rate difference between indicated and non-indicated ESD was found (cumulative recurrence 7.69% vs. 20%, p = 0.39) and a higher recurrence rate in patients with non-R0 resection compared with R0 resection (cumulative recurrence 0% vs. 40%, p < 0.01). However, the shorter duration of hospital stay in ESD group was noted in comparison to surgery (mean 5.67 days vs. 15.75 days, p < 0.01). The ESD patients have minor complications including bleeding, perforation and fever than surgery. Conclusion: ESD is a reasonable first line treatment in selected early gastric cancer in additional to surgery. Pre-treatment evaluation and post-ESD review of curability is crucial to further surveillance program or definite therapy including surgery. ? 2020 Formosan Medical Association |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/516203 | ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2020.08.027 | SDG/關鍵字: | adult; aged; anastomosis leakage; Article; cancer surgery; cancer survival; case control study; cohort analysis; comparative study; controlled study; disease specific survival; early cancer; endoscopic submucosal dissection; female; fever; human; length of stay; major clinical study; male; middle aged; perforation; postoperative hemorrhage; postoperative ileus; recurrence free survival; recurrence risk; retrospective study; stomach cancer; surgical infection; surgical patient; survival rate; Taiwan; teaching hospital; tertiary care center; treatment outcome; endoscopic mucosal resection; epidemiology; stomach mucosa; stomach tumor; tumor recurrence; Endoscopic Mucosal Resection; Gastric Mucosa; Humans; Neoplasm Recurrence, Local; Retrospective Studies; Stomach Neoplasms; Taiwan; Treatment Outcome |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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