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vol.73 suppl.1Clinical stage and histological type of the most common carcinomas diagnosed in young adults in a reference cancer hospitalSurgical treatment of gastric cancer: a 10-year experience in a high-volume university hospital author indexsubject indexarticles search
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Clinics

Print version ISSN 1807-5932On-line version ISSN 1980-5322

Abstract

MENDONCA, Ernesto Quaresma et al. Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center. Clinics [online]. 2018, vol.73, suppl.1, e553s.  Epub Oct 11, 2018. ISSN 1980-5322.  https://doi.org/10.6061/clinics/2018/e553s.

OBJECTIVE:

Our aim was to evaluate the Japan Gastroenterological Endoscopy Society criteria for endoscopic submucosal resection of early gastric cancer (EGC) based on the experience in a Brazilian cancer center.

METHODS:

We included all patients who underwent endoscopic submucosal resection for gastric lesions between February 2009 and October 2016. Demographic data and information regarding the endoscopic resection, pathological report and follow-up were obtained. Statistical calculations were performed with Fisher’s exact test and chi-square tests, with 95% confidence intervals.

RESULTS:

In total, 76% of the 51 lesions were adenocarcinomas, 16% were adenomas, and 8% had other diagnoses. The average size was 19.9 mm (±11.7). The average procedure length was 113.9 minutes (±71.4). The complication rate was 21.3%, with only one patient who needed surgical treatment (transmural perforation). Among the adenocarcinomas, 39.5% met the classic criteria for curability, 31.6% met the expanded criteria and 28.9% met the criteria for noncurative resection. Analysis of the indication criteria and curability revealed differences among cases with “only-by-size” expanded criteria (64.28%), other expanded criteria (40%) and classic criteria (89.47%), with a p-value of 0.049. During follow-up (15.8 months; ±14.3), 86.1% of the EGC patients had no recurrence. When well-differentiated and poorly differentiated lesions or lesions included in the classic and expanded criteria were compared, there were no differences in recurrence. The noncurative group presented a higher recurrence rate than the classic group (p=0.014).

CONCLUSION:

These results suggest that the Japanese endoscopic submucosal resection criteria might be useful for endoscopic treatment of EGC in Western countries.

Keywords : Endoscopic Mucosal Resection; Stomach Neoplasms; Gastrointestinal Endoscopy.

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