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- W3033138521 abstract "Endoscopic submucosal dissection (ESD) has become a widely accepted as a standard treatment for early gastric cancer (EGC) with differentiated histology. However, therapeutic outcome of ESD for undifferentiated cancer is still controversial. As ESD is a technique that leaves the at-risk native stomach, patients with EGC who have previously underwent ESD have the potential to develop metachronous gastric cancer (MGC). Given evidence has demonstrated that the cumulative incidence of MGC after endoscopic resection is not negligibly low. This study evaluated the incidence of MGC after complete endoscopic resection for EGC with undifferentiated histology. We retrospectively analyzed a prospectively collected registry (KHU-ESD registry) of clinical, endoscopic, and pathologic results of patients who underwent ESD for EGC. The study included 573 consecutive patients (465 differentiated and 108 undifferentiated carcinomas) who underwent complete endoscopic resection and followed more than 1 year. They were generally followed by annual esophagogastroduodenoscopy. Compared with differentiated carcinoma (DC group), we investigated the incidence of MGC in EGCs with undifferentiated histology (UDC group). Also, the risk factors for MGC were assessed over the follow-up period. The median follow-up duration was 4.2 (2.1-7.0) years in DC group and 4.8 (2.5-6.0) years in UDC group (P = 0.683). Younger and female patients were more common in the UDC group compared to the DC group (all P < 0.001). Whereas, patients with both atrophy and intestinal metaplasia (IM) were more common in the DC group than in the UDC group. Cumulative incidence of MGC was significantly higher in the DC group than in the UDC group (2.5% vs. 0.7% per person year, P = 0.011) (Fig. 1). In logistic regression analysis, undifferentiated histology was not associated with the development of MGC (OR 0.428, 95% CI 0.149-1.229, P = 0.115) and presence of synchronous cancer was a significant risk factor (OR 2.335, 95% CI 1.345-4.052, P = 0.003). Meanwhile, atrophy, IM, and Helicobacter pylori infection were not associated. In analysis of large number of EGCs with undifferentiated histology, the incidence of MGC after complete resection by ESD was lower than that of differentiated cancer. Therefore, if complete resection is expected, ESD can be considered as initial therapeutic modality for undifferentiated type EGC in term of metachronous recurrence." @default.
- W3033138521 created "2020-06-12" @default.
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- W3033138521 date "2020-06-01" @default.
- W3033138521 modified "2023-10-16" @default.
- W3033138521 title "Tu1523 METACHRONOUS CANCER AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY GASTRIC CANCER WITH UNDIFFERENTIATED HISTOLOGY: A RETROSPECTIVE ANALYSIS" @default.
- W3033138521 doi "https://doi.org/10.1016/j.gie.2020.03.3695" @default.
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