Journal of Gastric Cancer

  • 제24권2호
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  • Pages.199-209
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  • 2024
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Long-term Outcomes of Patients With Early Gastric Cancer Who Had Lateral Resection Margin-Positive Tumors Based on Pathology Following Endoscopic Submucosal Dissection

  • Jun Hee Lee (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Sang Gyun Kim (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Soo-Jeong Cho (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
  • 투고 : 2023.12.13
  • 심사 : 2024.03.04
  • 발행 : 2024.04.01
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초록

Purpose: Long-term outcomes of patients with positive lateral margins (pLMs) after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). This study aimed to evaluate the remnant cancer and survival rates of patients with pLMs compared with those who underwent curative resection. Materials and Methods: A retrospective analysis was performed on consecutive patients with pLMs as the only non-curative factor of expanded indication who underwent ESD for EGC with a follow-up duration of 5 years or more. The rates of remnant cancer, recurrence, and survival were analyzed and compared to those of control patients who underwent curative resection by propensity score matching. Results: Among 3,515 patients treated with ESD between 2005 and 2018, 123 non-curative EGCs were retrospectively analyzed. A total of 108 patients were followed up without endoscopic or surgical resection for 8.2 years. The control group was matched in a 1:1 ratio with patients with EGC who underwent curative resection after ESD. The observation group with pLMs had a higher incidence of remnant cancer (25.9%; 28/108) compared to that in the curative resection group (0/108; P=0.000). The remaining tumors were treated with surgical or endoscopic resection, and no additional recurrences were observed. The overall survival analysis demonstrated no significant difference between the observation and curative resection groups (P=0.577). Conclusions: No difference was observed in the overall survival rate between observation and curative resection groups. Therefore, observation may be a possible option for incomplete ESD with pLMs if continuous follow-up is performed.

키워드

과제정보

This research was supported by grants from the National Research Foundation of Korea (#NRF-2022R1A2B5B01001430) and the Korean Society of Gastrointestinal Endoscopy (2021). The funding source had no role in the study design, analysis, interpretation of the data, drafting of the article, critical revision of the article, and final approval for submission of the article.

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