144 Background: Endoscopic submucosal dissection (ESD) has been accepted as standard treatment for early gastric cancer. However, comparative outcomes of ESD and surgery have not been evaluated for adenocarcinoma in the esophagogastric junction (EGJ). We investigated the long-term outcomes of ESD compared with surgery for adenocarcinoma in the EGJ. Methods: Subjects who underwent ESD or surgery for Siewert type II adenocarcinoma which met absolute and expanded criteria between 2005 and 2010 were eligible for this study. Clinical features and treatment outcomes were retrospectively reviewed using medical records. Results: Among 79 patients included, 40 underwent ESD and 39 underwent surgery. During the median follow-up period of 60.9 months (range: 13.1-125.4 months), the 5-year overall survival rates were 93.9% and 97.3% for ESD and surgery groups, respectively ( p= 0.376). There was no gastric cancer-related deaths in either groups. Adverse events occurred in 11 patients (13.9%) overall and the incidence of treatment-related adverse events was similar between two groups (10.0% vs. 17.9%, p= 0.308). Conclusions: ESD may be an effective alternative to surgery for the treatment of early gastric cancer in the EGJ, based on comparable long-term outcomes.
Comparing long-term outcomes between endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for type II esophagogastric junction neoplasm
