scholarly journals The efficacy of the application of the curative criteria of the 5rd edition Japanese gastric cancer treatment guidelines for early adenocarcinoma of the esophagogastric junction treated by endoscopic submucosal dissection

2021 ◽  
Vol 27 (2) ◽  
pp. 97
Author(s):  
Guiqi Wang ◽  
Zhihao Chen ◽  
Yong Liu ◽  
Lizhou Dou ◽  
Yueming Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Cancer Treatment ◽  
Esophagogastric Junction ◽  
Treatment Guidelines ◽  
Submucosal Dissection ◽  
Early Adenocarcinoma ◽  
Gastric Cancer Treatment

scholarly journals Evaluation of the Japanese Gastric Cancer Association?s Gastric Cancer Treatment Guidelines for Popular Use

2004 ◽  
Vol 7 (1) ◽  
pp. 41-45
Author(s):  
Takashi Ichikura ◽  
Toshiya Ogawa ◽  
Takashi Majima ◽  
Susumu Saigusa ◽  
Yoshihisa Yaguchi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Treatment ◽  
Treatment Guidelines ◽  
Japanese Gastric Cancer Association ◽  
Gastric Cancer Treatment

Clinical benefit of the multibending endoscope for gastric endoscopic submucosal dissection: a randomized controlled trial

Endoscopy ◽  
2020 ◽  
Author(s):  
Koichi Hamada ◽  
Yoshinori Horikawa ◽  
Yoshiki Shiwa ◽  
Kae Techigawara ◽  
Takayuki Nagahashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Treatment Guidelines ◽  
Controlled Trial ◽  
Complete Removal ◽  
Muscle Layer ◽  
Gastrointestinal Neoplasms ◽  
Procedure Time ◽  
Operator Experience ◽  
Submucosal Dissection

Abstract Background Endoscopic submucosal dissection (ESD) is a technically difficult and time-consuming procedure. We aimed to investigate the efficacy and safety of ESD using a multibending endoscope to treat superficial gastrointestinal neoplasms. Methods Patients with a single early gastric cancer who met the absolute or expanded indications for ESD according to the Japanese gastric cancer treatment guidelines were enrolled and randomly assigned to undergo ESD using a conventional endoscope (C-ESD) or a multibending endoscope (M-ESD). Randomization was stratified by ESD operator experience and tumor location. The primary outcome was ESD procedure time, calculated as the time from the start of submucosal injection to complete removal of the tumor. Results 60 patients were analyzed (30 C-ESD, 30 M-ESD). The mean (standard deviation [SD]) ESD procedure times for M-ESD and C-ESD were 34.6 (SD 17.2) and 47.2 (SD 26.7) minutes, respectively (P = 0.03). Muscle layer damage occurred significantly less frequently with M-ESD (0.2 [SD 0.7] vs. 0.7 [SD 1.0]; P = 0.04). There were no significant differences between the two techniques in procedure time or damage to muscle layers for tumors located in the lower third of the stomach. Conclusions ESD procedure time was significantly shorter with the multibending endoscope and fewer muscles were damaged. We recommend multibending endoscopy for ESD in the upper and middle thirds of the stomach to reduce procedure time and incidence of complications.

scholarly journals Determination of Additional Surgery after Non-Curative Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer: A Practically Modified Application of the eCura System

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5768
Author(s):  
Sejin Lee ◽  
Jeong Ho Song ◽  
Sung Hyun Park ◽  
Minah Cho ◽  
Yoo Min Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
High Risk ◽  
Endoscopic Submucosal Dissection ◽  
Treatment Guidelines ◽  
Risk Group ◽  
Venous Invasion ◽  
High Risk Group ◽  
Submucosal Dissection ◽  
Additional Surgery

Background: Additional surgery after non-curative endoscopic submucosal dissection (ESD) may be excessive as few patients have lymph node metastasis (LNM). It is necessary to develop a risk stratification system for LNM after non-curative ESD, such as the eCura system, which was introduced in the Japanese gastric cancer treatment guidelines. However, the eCura system requires venous and lymphatic invasion to be separately assessed, which is difficult to distinguish without special immunostaining. In this study, we practically modified the eCura system by classifying lymphatic and venous invasion as lymphovascular invasion (LVI). Method: We retrospectively reviewed 543 gastric cancer patients who underwent radical gastrectomy after non-curative ESD between 2006 and 2019. LNM was evaluated according to LVI as well as size >30 mm, submucosal invasion ≥500 µm, and vertical margin involvement, which were used in the eCura system. Results: LNM was present in 8.1% of patients; 3.6%, 2.3%, 7.4%, 18.3%, and 61.5% of patients with no, one, two, three, and four risk factors had LNM, respectively. The LNM rate in the patients with no risk factors (3.6%) was not significantly different from that in patients with one risk factor (2.3%, p = 0.523). Among patients with two risk factors, the LNM rate without LVI was significantly lower than with LVI (2.4% vs. 10.7%, p = 0.027). Among patients with three risk factors, the LNM rate without LVI was lower than with LVI (0% vs. 20.8%, p = 0.195), although not statistically significantly. Based on LNM rates according to risk factors, patients with LVI and other factors were assigned to the high-risk group (LNM, 17.4%) while other patients as a low-risk group (LNM, 2.4%). Conclusions: Modifying the eCura system by classifying lymphatic and venous invasion as LVI successfully stratified LNM risk after non-curative ESD. Moreover, the high-risk group can be simply identified based on LVI and the presence of other risk factors.

Comparison of long-term outcomes of endoscopic submucosal dissection and surgery for esophagogastric junction adenocarcinoma.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 144-144
Author(s):  
Do Hoon Kim ◽  
Eun Jeong Gong ◽  
Ji Yong Ahn ◽  
Kee Wook Jung ◽  
Jeong Hoon Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Adverse Events ◽  
Endoscopic Submucosal Dissection ◽  
Esophagogastric Junction ◽  
Survival Rates ◽  
Long Term Outcomes ◽  
Siewert Type Ii ◽  
Submucosal Dissection

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.

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