内镜下黏膜下剥离术与手术治疗食管胃交界腺癌的长期疗效比较。
Comparison of long-term outcomes of endoscopic submucosal dissection and surgery for esophagogastric junction adenocarcinoma.
作者信息
Gong Eun Jeong, Kim Do Hoon, Ahn Ji Yong, Jung Kee Wook, Lee Jeong Hoon, Choi Kee Don, Song Ho June, Lee Gin Hyug, Jung Hwoon-Yong, Kim Hee Sung, Lee In-Seob, Kim Beom Su, Yoo Moon-Won, Oh Sung Tae, Yook Jeong Hwan, Kim Byung Sik
机构信息
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
出版信息
Gastric Cancer. 2017 Mar;20(Suppl 1):84-91. doi: 10.1007/s10120-016-0679-0. Epub 2016 Dec 19.
BACKGROUND
Endoscopic submucosal dissection (ESD) has become accepted as the 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 those of surgery for adenocarcinoma in the EGJ.
METHODS
Patients who underwent ESD or surgery for Siewert type II adenocarcinoma between 2005 and 2010 and who met the absolute and expanded criteria for endoscopic resection were eligible. Clinical features and treatment outcomes were retrospectively reviewed using medical records.
RESULTS
Of the 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 the ESD and surgery groups, respectively (p = 0.376). There were no gastric cancer-related deaths in either group. Adverse events occurred in 11 patients (13.9%) overall, and the incidence of treatment-related adverse events was similar between the 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 the comparable long-term outcomes.
背景
内镜黏膜下剥离术（ESD）已被公认为早期胃癌的标准治疗方法。然而，对于食管胃交界部（EGJ）腺癌，ESD与手术治疗的比较结果尚未得到评估。我们研究了EGJ腺癌ESD与手术治疗的长期结果。
方法
2005年至2010年间接受ESD或手术治疗Siewert II型腺癌且符合内镜切除绝对标准和扩展标准的患者符合条件。使用病历对临床特征和治疗结果进行回顾性分析。
结果
纳入的79例患者中，40例行ESD，39例行手术。在中位随访期60.9个月（范围13.1 - 125.4个月）内，ESD组和手术组的5年总生存率分别为93.9%和97.3%（p = 0.376）。两组均无胃癌相关死亡。总体上11例患者（13.9%）发生不良事件，两组治疗相关不良事件发生率相似（10.0%对17.9%，p = 0.308）。
结论
基于可比的长期结果，ESD可能是EGJ早期胃癌手术治疗的有效替代方法。
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