Mo1556 Long-Term Follow-up Investigation of the Expanded Indications for Endoscopic Submucosal Dissection of Submucosal Gastric Cancer

2011 ◽  
Vol 73 (4) ◽  
pp. AB385
Author(s):  
Shiro Oka ◽  
Shinji Tanaka ◽  
Yoji Sanomura ◽  
Makoto Higashiyama ◽  
Hiroki Imagawa ◽  
...  
Endoscopy ◽  
2017 ◽  
Vol 49 (09) ◽  
pp. 855-865 ◽  
Author(s):  
Andreas Probst ◽  
Annette Schneider ◽  
Tina Schaller ◽  
Matthias Anthuber ◽  
Alanna Ebigbo ◽  
...  

Abstract Background and study aims Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric cancer (EGC) fulfilling guideline resection criteria or the expanded resection criteria in Asia. It is unclear whether the expanded criteria can be transferred to European patients, and long-term follow-up data are lacking. The aim of this study was to evaluate long-term follow-up data after ESD of EGCs in Europe. Patients and methods Patients with EGC who underwent ESD were included in this single-center study at a German referral center. Patient and lesion characteristics, procedure characteristics, and follow-up data were recorded prospectively. Results A total of 179 patients with 191 EGCs were included over a period of 141 months, with 29.6 % of lesions meeting guideline criteria and 48.6 % meeting expanded criteria. The en bloc resection rate was 98.4 % for guideline criteria and 89.0 % for expanded criteria lesions (P = 0.09), and the R0 resection rate was 90.2 % and 73.6 %, respectively (P = 0.02). The main reason for the expanded criteria was a lesion diameter > 20 mm (81.6 %). Complications: perforation 1 %, delayed bleeding 6.3 %, stricture 2.1 %, procedure-related mortality 1.1 %. Local recurrence rate was 0 % for guideline criteria and 4.8 % for expanded criteria lesions (P = 0.06), and the rate of metachronous neoplasia was 15.1 % and 7.1 %, respectively (median follow-up 51 and 56 months, respectively); 92.9 % of metachronous neoplasia were treated curatively with repeat ESD. One patient developed lymph node metastasis after ESD of a submucosal invasive expanded criteria lesion. Long-term-survival was comparable between the two criteria (P = 0.58). No gastric cancer-related death was observed in either group. Conclusions ESD can achieve high rates of long-term curative treatment using the expanded criteria in EGCs in Western countries. We recommend ESD as treatment of choice not only for guideline criteria EGCs but also for intramucosal nonulcerated EGCs regardless of their diameter.


2014 ◽  
Vol 79 (5) ◽  
pp. AB239
Author(s):  
Tatsuya Toyokawa ◽  
Tomoki Inaba ◽  
Koichi Izumikawa ◽  
Isao Fujita ◽  
Shigenao Ishikawa ◽  
...  

2020 ◽  
Author(s):  
Toshio Watanabe ◽  
Yuji Nadatani ◽  
Wataru Suda ◽  
Akira Higashimori ◽  
Koji Otani ◽  
...  

Abstract Background Gastric microbiome, other than Helicobacter pylori, plays a role in the tumorigenesis of gastric cancer (GC). Patients who undergo endoscopic submucosal dissection for early GC have a high risk of developing metachronous GC even after successful eradication of H. pylori. Thus, we investigated the microbial profiles and associated changes in such patients after the eradication of H. pylori. Methods A total of 19 H. pylori-infected patients with early GC who were or to be treated by endoscopic resection, with paired biopsy samples at pre- and post-eradication therapy, were retrospectively enrolled. Ten H. pylori-negative patients were enrolled as controls. Biopsy samples were analyzed using 16S rRNA sequencing. Results H. pylori-positive patients exhibited low richness and evenness of bacteria with the deletion of several genera, including Blautia, Ralstonia, Faecalibacterium, Methylobacterium, and Megamonas. H. pylori eradication partially restored microbial diversity, as assessed during a median follow-up at 13 months after eradication therapy. However, post-eradication patients had less diversity than that in the controls and possessed a lower abundance of the five genera mentioned above. The eradication of H. pylori also altered the bacterial composition, but not to the same extent as that in controls. The microbial communities could be clustered into three separate groups: H. pylori-negative, pre-eradication, and post-eradication. Conclusion Changes in dysbiosis may persist long after the eradication of H. pylori in patients with a history of GC. Dysbiosis may be involved in the development of both primary and metachronous GC after the eradication of H. pylori in such patients.


2020 ◽  
Vol 91 (6) ◽  
pp. AB481-AB482
Author(s):  
Stavros N. Stavropoulos ◽  
Xiaocen Zhang ◽  
Erin K. Ly ◽  
Mengdan Xie ◽  
Maaz B. Badshah ◽  
...  

Author(s):  
Julia Arribas Anta ◽  
Ángel Cañete Ruiz ◽  
Teresa Álvarez-Nava Torrego ◽  
Carlos Piedracoba-Cadahía ◽  
David Rafael de la Cruz Esteban ◽  
...  

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