Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center

Detalhes bibliográficos
Autor(a) principal: Mendonça, Ernesto Quaresma
Data de Publicação: 2019
Outros Autores: 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
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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spelling 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
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