PROGNOSTIC INFLUENCE OF ADDITIONAL SURGERY FOR GASTRIC CANCERS WITH SUBMUCOSAL INVASION CLASSIFIED INTO NON-CURATIVE RESECTION AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION IN ELDERLY PATIENTS

2020 ◽  
Author(s):  
Y Takagi ◽  
K Yamamoto ◽  
T Michida ◽  
Y Tokuda ◽  
S Hiyama ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Curative Resection ◽  
Submucosal Invasion ◽  
Gastric Cancers ◽  
Submucosal Dissection ◽  
Additional Surgery

scholarly journals Advanced Colon Cancer after Curative Resection of Intramucosal Adenocarcinoma with Endoscopic Submucosal Dissection

2021 ◽  
pp. 603-609
Author(s):  
Akiko Sasaki ◽  
Chikamasa Ichita ◽  
Chihiro Sumida ◽  
Karen Kimura ◽  
Takashi Nishino ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Advanced Cancer ◽  
Curative Resection ◽  
Submucosal Tumor ◽  
R0 Resection ◽  
Surveillance Colonoscopy ◽  
Epithelial Tumor ◽  
Submucosal Dissection ◽  
Intramucosal Adenocarcinoma

Endoscopic resection, particularly endoscopic submucosal dissection (ESD), for colorectal cancers enables a precise pathological diagnosis and safe R0 resection. The recurrence rate after ESD is generally extremely low, with annual surveillance colonoscopy recommended. However, surveillance may not be considered for super-elderly patients owing to their condition. This is a case report of an 85-year-old man in whom curative resection was achieved for an intramucosal adenocarcinoma with ESD. The patient presented with a hypoechoic mass located in his lower right abdomen, diagnosed via surveillance abdominal ultrasound. He had undergone curative ESD for intramucosal cecal cancer 2 years prior. Colonoscopy revealed a type 2 epithelial tumor at the proximal aspect of the ESD scar. Ileocolic resection with lymph node dissection was performed. An epithelial tumor and well-differentiated adenocarcinoma but not a submucosal tumor was detected in the mucosal layer. The lesion was diagnosed not as a local recurrence after ESD but as a newly emerged original advanced cancer. After ESD for colorectal cancer, a newly developed advanced cancer may occur at the site of the ESD scar in a shorter term than usual. Surveillance colonoscopy after ESD is necessary even for super-elderly patients.

scholarly journals Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review

2020 ◽  
Vol 9 (5) ◽  
pp. 1465
Author(s):  
Chang Seok Bang ◽  
Jae Jun Lee ◽  
Gwang Ho Baik
Keyword(s):  
Systematic Review ◽  
Endoscopic Submucosal Dissection ◽  
Curative Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Complete Resection ◽  
Submucosal Invasion ◽  
High Rate ◽  
En Bloc ◽  
Submucosal Dissection

This study evaluated the possibility of endoscopic submucosal dissection (ESD) for early gastric cancer with papillary adenocarcinoma (EGC-PAC). PAC, an uncommon pathologic type of stomach cancer, is classified into differentiated-type histology. However, aggressive features, including a high rate of submucosal invasion, lymphovascular invasion (LVI), and lymph node metastasis (LNM), have been reported in studies with surgical specimens. Treatment outcomes of ESD for EGC-PAC have not been precisely demonstrated. Core databases were sought for the following inclusion criteria: studies of endoscopic resection or surgery of EGC-PAC presenting the following therapeutic indicators; en bloc resection, complete resection, curative resection, recurrence, complications associated with procedures, LVI, or LNM that enabled an analysis of ESD possibility. Overall, 15 studies were included for systematic review. Frequent submucosal invasion and high LVI were noted in EGC-PAC. However, PAC was not significantly associated with LNM. Pooled en bloc resection, complete resection, and curative resection rates were 89.7% (95% confidence interval: 55.3%–98.4%), 85.3% (67.7%–94.2%), and 67% (43%–84.5%), respectively. No LNM was observed if EGC-PAC satisfied the curative resection criteria. ESD seems technically feasible, although a high LVI rate results in a lower rate of curative resection.

Risk of recurrence when cutting into intramucosal (pT1a) cancer from the cutting-plane side during gastric endoscopic submucosal dissection

Endoscopy ◽  
2020 ◽  
Vol 52 (10) ◽  
pp. 833-838
Author(s):  
Hiroko Nakahira ◽  
Takashi Kanesaka ◽  
Noriya Uedo ◽  
Masayasu Ohmori ◽  
Hiroyoshi Iwagami ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Endoscopic Submucosal Dissection ◽  
Cutting Plane ◽  
Risk Of Recurrence ◽  
Gastric Cancers ◽  
Submucosal Dissection ◽  
Additional Surgery ◽  
Risk Factors For Recurrence ◽  
Surveillance Endoscopy

Background During endoscopic submucosal dissection (ESD), procedural difficulty and poor visibility of the cutting plane sometimes cause the operator to cut into the lesion from the cutting-plane side, making the vertical margin positive (VM1) or unclear (VMX). In the present study, we evaluated the risk of recurrence of gastric cancer with VM1 /VMX after ESD. Methods In total, 1723 consecutive gastric cancers treated by ESD at Osaka International Cancer Institute from July 2012 to December 2017 were included in this retrospective cohort study. Among them, 231 submucosal or more deeply invasive gastric cancers were excluded because nontechnical factors may contribute to VM1 /VMX in such lesions. To quantify the risk of cutting into cancer from the cutting-plane side during ESD, the proportion of lesions with VM1 /VMX among the pT1a gastric cancers treated by ESD was calculated. The proportion of recurrence among these cases was calculated after exclusion of lesions with positive lymphovascular invasion or a positive horizontal margin in order to eliminate the obvious risk factors for recurrence. Results Among 1492 pT1a gastric cancers treated by ESD, 28 lesions (1.9 %; 95 % confidence interval [CI] 1.3 % – 2.7 %) histologically showed VM1 /VMX. No local recurrence (0.0 %; 95 %CI 0.0 % – 12.2 %) occurred among 23 cases. The median follow-up period was 41 months (range 10 – 84 months). Conclusions No local recurrence was detected in pT1a gastric cancers after VM1 /VMX resection by ESD. Surveillance endoscopy could be adopted for such cases without additional surgery.

FEASIBILITY OF ENDOSCOPIC SUBMUCOSAL DISSECTION FOR ELDERLY PATIENTS WITH EARLY GASTRIC CANCERS AND ADENOMAS

2007 ◽  
Vol 20 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Yasuhiro Onozato ◽  
Satoru Kakizaki ◽  
Hiroshi Ishihara ◽  
Haruhisa Iizuka ◽  
Naondo Sohara ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Gastric Cancers ◽  
Submucosal Dissection

scholarly journals Endoscopic submucosal dissection of malignant non-pedunculated colorectal lesions

2018 ◽  
Vol 06 (08) ◽  
pp. E961-E968 ◽  
Author(s):  
Carl-Fredrik Rönnow ◽  
Jacob Elebro ◽  
Ervin Toth ◽  
Henrik Thorlacius
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Curative Resection ◽  
Residual Tumor ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
R0 Resection ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Additional Surgery ◽  
Procedural Time

Abstract Background and study aims Endoscopic submucosal dissection (ESD) is an established method for en bloc resection of large non-pedunculated colorectal lesions in Asia but dissemination of ESD in Western countries is limited. The aim of this study was to evaluate the role of ESD in the management of malignant non-pedunculated colorectal lesions in a European center. Patients and methods Among 255 patients undergoing colorectal ESD between 2014 and 2016, 29 cases were identified as submucosal invasive cancers and included in this study. The main outcomes were en bloc, R0 and curative resection as well as procedural time, complications and recurrence. Results Median tumor size was 40 mm (range 20 – 70 mm). Thirteen cancers were located in the colon and 16 were located in the rectum. Procedural time was 89 minutes (range 18 – 594 minutes). Complete resection was achieved in 28 cases, en bloc and R0 resection rates were 83 % and 69 %, respectively. Curative resection rate was 38 %. One case had a perforation in the sigmoid colon requiring emergency surgery. No significant bleeding occurred. Six patients underwent additional surgery after ESD, one of whom had residual tumor. One recurrence was detected in 20 patients that were followed-up endoscopically, median follow-up time was 13 months (range 2 – 30 months). Conclusion ESD seems to be a safe and effective method for treating non-pedunculated malignant colorectal lesions after careful patient selection and proper endoscopic training.

Additional surgery for non-curative resection after endoscopic submucosal dissection for gastric cancer: a retrospective analysis of 200 cases

Surgery Today ◽  
2016 ◽  
Vol 47 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Hideki Sunagawa ◽  
Takahiro Kinoshita ◽  
Akio Kaito ◽  
Hidehito Shibasaki ◽  
Kazuhiro Kaneko ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Retrospective Analysis ◽  
Curative Resection ◽  
Submucosal Dissection ◽  
Additional Surgery

Usefulness of endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma in elderly patients: a single-center retrospective cohort study

2021 ◽  
Author(s):  
Kenji Ishido ◽  
Satoshi Tanabe ◽  
Chikatoshi Katada ◽  
Yo Kubota ◽  
Yasuaki Furue ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Curative Resection ◽  
The Elderly ◽  
Elderly Group ◽  
Submucosal Dissection

Abstract Background The effectiveness of endoscopic treatment for superficial esophageal squamous cell carcinoma in the elderly is unclear. Methods We retrospectively studied efficacy and safety of endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma in 358 patients at our hospital from July 2005 to December 2018. Patients were divided into elderly (≥75 years) and young (≤74 years) groups. Efficacy was evaluated based on overall survival and disease-specific survival, whereas safety was investigated based on the frequency of endoscopic submucosal dissection-related adverse events. Results The median observation period was 50 months. The elderly group comprised 111 patients, and young group comprised 247 patients. In the elderly and young groups, 76 (68.5%) and 159 (64.4%) underwent curative resection (P = 0.450), 8 (7.2%) and 34 (13.8%) underwent non-curative resection plus additional treatment and 12 (10.8%) and 15 (6.0%) underwent follow-up, respectively. The frequency of additional treatment for non-curative resection was significantly lower in the elderly group (P = 0.023). The 3-year overall survival of the elderly and young groups was 85.6 and 94.1%, respectively (P = 0.003). The 3-year disease-specific survival of the elderly and young groups was 98.4 and 98.5% (P = 0.682), respectively. The frequency of endoscopic submucosal dissection-related adverse events did not differ significantly between the groups (P = 0.581). The Charlson Comorbidity Index ≥2 was an independent prognostic factor for survival in the elderly group (P = 0.010; hazard ratio, 5.570; 95% confidence interval, 1.519–20.421). Conclusions Endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma in elderly patients is as safe as that for young patients. The evaluation of Charlson Comorbidity Index was considered to help estimate the prognosis of elderly patients.

scholarly journals Recurrence rate of intramucosal gastric cancer with positive vertical margin due to lesion damage during endoscopic submucosal dissection

2021 ◽  
Vol 84 (2) ◽  
pp. 289-294
Author(s):  
J Hayasaka ◽  
D Kikuchi ◽  
K Nomura ◽  
H Odagiri ◽  
Y Ochiai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Confidence Interval ◽  
Endoscopic Submucosal Dissection ◽  
Recurrence Rate ◽  
Curative Resection ◽  
Recurrence Rates ◽  
Submucosal Dissection ◽  
Additional Surgery ◽  
Significant Difference ◽  
Margin Positive

Background and study aim: In principle, additional surgery is performed after endoscopic submucosal dissection for early gastric cancer if the vertical margin is positive, regardless of lesion damage. The recurrence rate of vertical margin-positive lesions due to lesion damage after endoscopic submucosal dissection is unknown, and unnecessary surgeries may be performed. In this study, we investigated whether there was a difference in the recurrence rate between vertical margin-positive lesions due to lesion damage and vertical margin-negative lesions. Patients and methods: We included 1,294 intramucosal gastric cancer lesions that were resected by endoscopic submucosal dissection between January 2008 and December 2016, without additional surgery. The lesions were divided into the Damage and No damage groups based on vertical margin status. The Damage group had only one non-curative indication: a positive vertical margin due to lesion damage. The No damage group had no non curative indications. We compared the recurrence rate between the Damage and No damage groups. Results: The recurrence rates of the Damage and No damage groups were 0% (0/23; 95% confidence interval: 0-14.8%) and 0% (0/1,271; 95% confidence interval: 0-0.003%), respectively, with no statistically significant difference. Conclusions: In intramucosal gastric cancer, the recurrence rate of vertical margin-positive lesions due to lesion damage was 0%, which did not differ from that of vertical margin-negative lesions with curative resection. Follow-up, instead of additional surgery, may be an option for patients with non-curative resection when the only non-curative indication is a positive vertical margin due to lesion damage.

Sign in / Sign up

Export Citation Format

Share Document