Treatment outcomes of non-curative endoscopic submucosal dissection for superficial gastric neoplasia: A retrospective study at a tertiary care center in the United States Journal Article
| Authors: | Nagao, S.; Nishimura, M.; Koseki, M.; Beauvais, J.; Laszkowska, M.; Tang, L.; Strong, V. E.; Schattner, M. A. |
| Article Title: | Treatment outcomes of non-curative endoscopic submucosal dissection for superficial gastric neoplasia: A retrospective study at a tertiary care center in the United States |
| Abstract: | Objectives: Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer; additional treatment may be recommended for patients in whom resection is not curative per the American Society for Gastrointestinal Endoscopy guidelines. The aim of this study was to assess treatment outcomes of ESD for gastric neoplasia, with a focus on cases of non-curative resection. Methods: This was a retrospective study of all individuals undergoing ESD for the treatment of gastric adenocarcinoma or dysplasia in a high-volume tertiary care center in the United States. Data on patient demographic characteristics, clinical history, lesion characteristics, and procedural and clinical outcomes were collected from the electronic medical record. Results: Among 82 cases undergoing ESD for the management of gastric neoplasia, 32 cases resulted in non-curative resection. 20 of these non-curative cases did not get additional treatment, among which recurrence occurred in two cases with positive horizontal margins only. These patients did not show lymph node metastasis and underwent further endoscopic or surgical resection. There was no recurrence in 11 cases with undifferentiated carcinomas of ≤2 cm in size. Conclusions: Although this study was limited by its retrospective design, small sample size, and follow-up duration, our findings suggest that a risk-adapted strategy could be employed for certain patients undergoing non-curative ESD per American Society for Gastrointestinal Endoscopy guidelines, with close follow-up instead of routine surgery in select cases with favorable features. Further studies are needed to refine the criteria for additional treatment after non-curative ESD in Western populations. © 2024 The Author(s). DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society. |
| Keywords: | treatment outcome; lymph node metastasis; dysplasia; endoscopic submucosal dissection; early gastric cancer |
| Journal Title: | DEN Open |
| Volume: | 5 |
| Issue: | 1 |
| ISSN: | 2692-4609 |
| Publisher: | John Wiley & Sons |
| Date Published: | 2025-04-01 |
| Start Page: | e70034 |
| Language: | English |
| DOI: | 10.1002/deo2.70034 |
| PROVIDER: | scopus |
| PMCID: | PMC11547226 |
| PUBMED: | 39524150 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Makoto Nishimura -- Source: Scopus |
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