Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/154745 |
Resumo: | 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. |
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Clinics |
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Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer centerEndoscopic Mucosal ResectionStomach NeoplasmsGastrointestinal EndoscopyOBJECTIVE: 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.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2019-02-14info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/15474510.6061/clinics/2018/e553sClinics; Vol. 73 No. Suppl. 1 (2018); e553sClinics; v. 73 n. Suppl. 1 (2018); e553sClinics; Vol. 73 Núm. Suppl. 1 (2018); e553s1980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/154745/150776Copyright (c) 2019 Clinicsinfo:eu-repo/semantics/openAccessMendonça, Ernesto QuaresmaPessorrusso, Fernanda Cristina SimõesRamos, Marcus Fernando Kodama PertilleJacob, Carlos EduardoOliveira, Joel Fernandez deRibeiro, Maria SylviaSafatle-Ribeiro, AdrianaZilberstein, BrunoRibeiro Júnior, UlyssesMaluf-Filho, Fauze2019-05-14T11:48:25Zoai:revistas.usp.br:article/154745Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2019-05-14T11:48:25Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center |
title |
Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center |
spellingShingle |
Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center Mendonça, Ernesto Quaresma Endoscopic Mucosal Resection Stomach Neoplasms Gastrointestinal Endoscopy |
title_short |
Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center |
title_full |
Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center |
title_fullStr |
Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center |
title_full_unstemmed |
Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center |
title_sort |
Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center |
author |
Mendonça, Ernesto Quaresma |
author_facet |
Mendonça, Ernesto Quaresma Pessorrusso, Fernanda Cristina Simões Ramos, Marcus Fernando Kodama Pertille Jacob, Carlos Eduardo Oliveira, Joel Fernandez de Ribeiro, Maria Sylvia Safatle-Ribeiro, Adriana Zilberstein, Bruno Ribeiro Júnior, Ulysses Maluf-Filho, Fauze |
author_role |
author |
author2 |
Pessorrusso, Fernanda Cristina Simões Ramos, Marcus Fernando Kodama Pertille Jacob, Carlos Eduardo Oliveira, Joel Fernandez de Ribeiro, Maria Sylvia Safatle-Ribeiro, Adriana Zilberstein, Bruno Ribeiro Júnior, Ulysses Maluf-Filho, Fauze |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Mendonça, Ernesto Quaresma Pessorrusso, Fernanda Cristina Simões Ramos, Marcus Fernando Kodama Pertille Jacob, Carlos Eduardo Oliveira, Joel Fernandez de Ribeiro, Maria Sylvia Safatle-Ribeiro, Adriana Zilberstein, Bruno Ribeiro Júnior, Ulysses Maluf-Filho, Fauze |
dc.subject.por.fl_str_mv |
Endoscopic Mucosal Resection Stomach Neoplasms Gastrointestinal Endoscopy |
topic |
Endoscopic Mucosal Resection Stomach Neoplasms Gastrointestinal Endoscopy |
description |
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. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-02-14 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/154745 10.6061/clinics/2018/e553s |
url |
https://www.revistas.usp.br/clinics/article/view/154745 |
identifier_str_mv |
10.6061/clinics/2018/e553s |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/154745/150776 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2019 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2019 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 73 No. Suppl. 1 (2018); e553s Clinics; v. 73 n. Suppl. 1 (2018); e553s Clinics; Vol. 73 Núm. Suppl. 1 (2018); e553s 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222763745542144 |