Long-term survival after endoscopic resection versus surgery in early gastric cancers

Young Il Kim, Young Woo Kim, Il Ju Choi, Chan Gyoo Kim, Jong Yeul Lee, Soo Jeong Cho, Bang Wool Eom, Hong Man Yoon, Keun Won Ryu, Myeong Cheorl Kook

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Abstract

Background and study aim: Endoscopic resection for early gastric cancers that meet the expanded indication is considered to be an investigational treatment. The study aim was to evaluate long-term outcomes of endoscopic resection compared with surgery for early gastric cancers meeting the expanded indication. Methods: We retrospectively reviewed data from patients who underwent endoscopic resection or surgery for gastric cancers meeting the expanded indication between 2001 and 2009. Overall survival rate was the primary outcome; gastric cancer recurrence rates and complication rates were secondary outcomes. Results: Among 457 patients included, 165 underwent endoscopic resection and 292 surgery, with median follow-up duration of 58.6 months. The 5-year overall survival rates were 97.5% and 97.0% for endoscopic resection and surgery, respectively; Kaplan-Meier analysis showed no significant difference (P=0.425). The 5-year gastric cancer recurrence rate was higher for endoscopic resection than for surgery (4.8% vs. 0.3%; P<0.001) mainly because of metachronous cancers which developed only in the endoscopic resection group (9/165, 5.5%). Most of the metachronous cancers (88.9%) were curatively treated with endoscopic resection. Early complication rates were similar between the groups (P=0.557), but the endoscopic resection group had more grade III or higher complications according to the Clavien-Dindo classification compared with the surgery group (4.8% vs. 1.4%, P=0.026). Late complications occurred only following surgery (4.8%, P=0.004), and most (92.9%) were grade III or higher. Conclusions: Endoscopic resection may be an optimal alternative to surgery for gastric cancers that meet the expanded indication criteria, because of a comparable long-term overall survival rate.

Original languageEnglish
JournalEndoscopy
Volume45
Issue number4
DOIs
StatePublished - 2015

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Stomach Neoplasms
Survival
Survival Rate
Recurrence
Investigational Therapies
Kaplan-Meier Estimate
Neoplasms

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Kim, Y. I., Kim, Y. W., Choi, I. J., Kim, C. G., Lee, J. Y., Cho, S. J., ... Kook, M. C. (2015). Long-term survival after endoscopic resection versus surgery in early gastric cancers. Endoscopy, 45(4). https://doi.org/10.1055/s-0034-1391284
Kim, Young Il ; Kim, Young Woo ; Choi, Il Ju ; Kim, Chan Gyoo ; Lee, Jong Yeul ; Cho, Soo Jeong ; Eom, Bang Wool ; Yoon, Hong Man ; Ryu, Keun Won ; Kook, Myeong Cheorl. / Long-term survival after endoscopic resection versus surgery in early gastric cancers. In: Endoscopy. 2015 ; Vol. 45, No. 4.
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title = "Long-term survival after endoscopic resection versus surgery in early gastric cancers",
abstract = "Background and study aim: Endoscopic resection for early gastric cancers that meet the expanded indication is considered to be an investigational treatment. The study aim was to evaluate long-term outcomes of endoscopic resection compared with surgery for early gastric cancers meeting the expanded indication. Methods: We retrospectively reviewed data from patients who underwent endoscopic resection or surgery for gastric cancers meeting the expanded indication between 2001 and 2009. Overall survival rate was the primary outcome; gastric cancer recurrence rates and complication rates were secondary outcomes. Results: Among 457 patients included, 165 underwent endoscopic resection and 292 surgery, with median follow-up duration of 58.6 months. The 5-year overall survival rates were 97.5{\%} and 97.0{\%} for endoscopic resection and surgery, respectively; Kaplan-Meier analysis showed no significant difference (P=0.425). The 5-year gastric cancer recurrence rate was higher for endoscopic resection than for surgery (4.8{\%} vs. 0.3{\%}; P<0.001) mainly because of metachronous cancers which developed only in the endoscopic resection group (9/165, 5.5{\%}). Most of the metachronous cancers (88.9{\%}) were curatively treated with endoscopic resection. Early complication rates were similar between the groups (P=0.557), but the endoscopic resection group had more grade III or higher complications according to the Clavien-Dindo classification compared with the surgery group (4.8{\%} vs. 1.4{\%}, P=0.026). Late complications occurred only following surgery (4.8{\%}, P=0.004), and most (92.9{\%}) were grade III or higher. Conclusions: Endoscopic resection may be an optimal alternative to surgery for gastric cancers that meet the expanded indication criteria, because of a comparable long-term overall survival rate.",
author = "Kim, {Young Il} and Kim, {Young Woo} and Choi, {Il Ju} and Kim, {Chan Gyoo} and Lee, {Jong Yeul} and Cho, {Soo Jeong} and Eom, {Bang Wool} and Yoon, {Hong Man} and Ryu, {Keun Won} and Kook, {Myeong Cheorl}",
year = "2015",
doi = "10.1055/s-0034-1391284",
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Kim, YI, Kim, YW, Choi, IJ, Kim, CG, Lee, JY, Cho, SJ, Eom, BW, Yoon, HM, Ryu, KW & Kook, MC 2015, 'Long-term survival after endoscopic resection versus surgery in early gastric cancers', Endoscopy, vol. 45, no. 4. https://doi.org/10.1055/s-0034-1391284

Long-term survival after endoscopic resection versus surgery in early gastric cancers. / Kim, Young Il; Kim, Young Woo; Choi, Il Ju; Kim, Chan Gyoo; Lee, Jong Yeul; Cho, Soo Jeong; Eom, Bang Wool; Yoon, Hong Man; Ryu, Keun Won; Kook, Myeong Cheorl.

In: Endoscopy, Vol. 45, No. 4, 2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term survival after endoscopic resection versus surgery in early gastric cancers

AU - Kim, Young Il

AU - Kim, Young Woo

AU - Choi, Il Ju

AU - Kim, Chan Gyoo

AU - Lee, Jong Yeul

AU - Cho, Soo Jeong

AU - Eom, Bang Wool

AU - Yoon, Hong Man

AU - Ryu, Keun Won

AU - Kook, Myeong Cheorl

PY - 2015

Y1 - 2015

N2 - Background and study aim: Endoscopic resection for early gastric cancers that meet the expanded indication is considered to be an investigational treatment. The study aim was to evaluate long-term outcomes of endoscopic resection compared with surgery for early gastric cancers meeting the expanded indication. Methods: We retrospectively reviewed data from patients who underwent endoscopic resection or surgery for gastric cancers meeting the expanded indication between 2001 and 2009. Overall survival rate was the primary outcome; gastric cancer recurrence rates and complication rates were secondary outcomes. Results: Among 457 patients included, 165 underwent endoscopic resection and 292 surgery, with median follow-up duration of 58.6 months. The 5-year overall survival rates were 97.5% and 97.0% for endoscopic resection and surgery, respectively; Kaplan-Meier analysis showed no significant difference (P=0.425). The 5-year gastric cancer recurrence rate was higher for endoscopic resection than for surgery (4.8% vs. 0.3%; P<0.001) mainly because of metachronous cancers which developed only in the endoscopic resection group (9/165, 5.5%). Most of the metachronous cancers (88.9%) were curatively treated with endoscopic resection. Early complication rates were similar between the groups (P=0.557), but the endoscopic resection group had more grade III or higher complications according to the Clavien-Dindo classification compared with the surgery group (4.8% vs. 1.4%, P=0.026). Late complications occurred only following surgery (4.8%, P=0.004), and most (92.9%) were grade III or higher. Conclusions: Endoscopic resection may be an optimal alternative to surgery for gastric cancers that meet the expanded indication criteria, because of a comparable long-term overall survival rate.

AB - Background and study aim: Endoscopic resection for early gastric cancers that meet the expanded indication is considered to be an investigational treatment. The study aim was to evaluate long-term outcomes of endoscopic resection compared with surgery for early gastric cancers meeting the expanded indication. Methods: We retrospectively reviewed data from patients who underwent endoscopic resection or surgery for gastric cancers meeting the expanded indication between 2001 and 2009. Overall survival rate was the primary outcome; gastric cancer recurrence rates and complication rates were secondary outcomes. Results: Among 457 patients included, 165 underwent endoscopic resection and 292 surgery, with median follow-up duration of 58.6 months. The 5-year overall survival rates were 97.5% and 97.0% for endoscopic resection and surgery, respectively; Kaplan-Meier analysis showed no significant difference (P=0.425). The 5-year gastric cancer recurrence rate was higher for endoscopic resection than for surgery (4.8% vs. 0.3%; P<0.001) mainly because of metachronous cancers which developed only in the endoscopic resection group (9/165, 5.5%). Most of the metachronous cancers (88.9%) were curatively treated with endoscopic resection. Early complication rates were similar between the groups (P=0.557), but the endoscopic resection group had more grade III or higher complications according to the Clavien-Dindo classification compared with the surgery group (4.8% vs. 1.4%, P=0.026). Late complications occurred only following surgery (4.8%, P=0.004), and most (92.9%) were grade III or higher. Conclusions: Endoscopic resection may be an optimal alternative to surgery for gastric cancers that meet the expanded indication criteria, because of a comparable long-term overall survival rate.

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U2 - 10.1055/s-0034-1391284

DO - 10.1055/s-0034-1391284

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C2 - 25625697

AN - SCOPUS:84964266995

VL - 45

JO - Endoscopy

JF - Endoscopy

SN - 0013-726X

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