Ojima Toshiyasu, Takifuji Katsunari, Nakamura Masaki, Nakamori Mikihito, Yamaue Hiroki
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.
Surg Laparosc Endosc Percutan Tech. 2016 Oct;26(5):401-405. doi: 10.1097/SLE.0000000000000315.
The purpose of this study was to determine the feasibility of the endoscopic submucosal dissection (ESD) for submucosal-invasive gastric cancer (SMGC) by assessing the therapeutic outcomes in patients treated with ESD.
From 2002 to 2013, ESD was performed for 597 lesions with early gastric cancer at our institute. ESD of the SMGC was performed for 85 patients.
Among these 85 patients, 35 patients underwent additional gastrectomy. Residual or recurrent cancer occurred in 12 patients treated through ESD method. The 5-year disease-specific survival rates were 94.9% for all 85 patients and 97.2% for 49 patients with follow-up examinations after ESD. The multivariate logistic regression analysis indicated that residual or recurrent cancer in the patients with SMGC was significantly associated with a tumor width in submucosa (P=0.0152).
ESD for SMGC can be considered feasible in clinical practice in terms of the favorable long-term oncologic outcomes.
本研究的目的是通过评估接受内镜黏膜下剥离术（ESD）治疗的患者的治疗效果，确定ESD治疗黏膜下浸润性胃癌（SMGC）的可行性。
2002年至2013年，我院对597例早期胃癌病变进行了ESD。对85例SMGC患者进行了ESD。
在这85例患者中，35例患者接受了额外的胃切除术。12例通过ESD方法治疗的患者出现了残留或复发性癌症。85例患者的5年疾病特异性生存率为94.9%，49例ESD后接受随访检查的患者为97.2%。多因素逻辑回归分析表明，SMGC患者的残留或复发性癌症与黏膜下肿瘤宽度显著相关（P = 0.0152）。
就良好的长期肿瘤学结果而言，ESD治疗SMGC在临床实践中可被认为是可行的。
