Efficacy and safety of endoscopic submucosal dissection for gastric tube cancer: A multicenter retrospective study

Table 1 Patients’ characteristics and endoscopic findings

Characteristics
Patients/lesions, n	38/48
Median age, yr (range)	71.5 (57-84)
Sex, n (%)
Male	34 (89)
Female	4 (11)
Median period from esophagectomy to ESD for GTC, d (range)	2106 (38-9523)
Reconstruction route of gastric tube, n (%)
Antethoracic	7 (18)
Retrosternal	11 (29)
Posterior mediastinal	20 (53)
Median observation period after ESD, d (range)	884 (8-4040)
Location of lesion, n (%)
U	2 (4)
M	18 (38)
L	28 (58)
Macroscopic type, n (%)
0-IIa	21 (44)
0-IIb	2 (4)
0-IIc	22 (46)
0-III	1 (2)
Combined	2 (4)

ESD: Endoscopic submucosal dissection; GTC: Gastric tube cancer; U: Upper; M: Medium; L: Lower.

Table 2 Treatment results of endoscopic submucosal dissection for gastric tube cancer and histopathological findings

Lesions, n	48
Median procedure time, min (range)	81 (29-334)
En bloc resection, n (%)	44 (91.7)
Adverse events during ESD, n (%)
Bleeding	1(2)
Perforation	1(2)
Adverse events post ESD, n (%)
Bleeding	2 (4)
Subcutaneous abscess	1 (2)
Liver failure	1 (2)
Respiratory failure	1 (2)
Median tumor size, mm (range)	15 (4-60)
Histrogical type, n
Differentiated	43
Undifferentiated	5
Tumor depth, n
M	40
SM1	4
SM2	4
Ulcerative findings, n
Absent	41
Present	7
Lymphatic infiltration, n
Negative	3
Positive	45
Lymphatic infiltration, n
Negative	1
Positive	47
Horizontal margin, n
Negative	45
Positive	3
Vertical margin, n
Negative	47
Positive	1
eCura, n (%)
A	38 (79)
C-1	3 (6)
C-2	7 (15)

ESD: Endoscopic submucosal dissection; M: Intramucosal; SM1: Submucosal superficial; SM2: Submucosal deep invasive.

Table 3 Comparison of clinical outcomes between Okayama University Hospital and other hospitals

Institution (patients/lesions)	OUH (17/20)	Other hospitals (21/28)	P value
Median age, yr (range)	70 (57-83)	73 (58-84)	0.28
Male, n (%)	15 (88)	19 (79)	0.72
Reconstruction route of gastric tube, n			< 0.01
Antethoracic	7	0
Retrosternal	7	4
Posterior mediastinal	3	17
Median tumor size, mm (range)	18 (8-60)	15 (4-40)	0.21
depth, M/SM, n	16/4	24/4	0.6
Ulcerative findings positive, n (%)	3 (15)	4 (14)	0.94
Median procedure time, min (range)	50 (20-180)	108 (32-334)	< 0.01
En bloc resection, n (%)	19 (95)	25 (89)	0.48
Curative resection (eCura A or B), n (%)	17 (85)	21 (75)	0.4
Adverse events during ESD, n (%)	1 (5.0)	1 (3.6)	0.8
Adverse events post ESD, n (%)	3 (15)	2 (7.1)	0.37

OUH: Okayama University Hospital; ESD: Endoscopic submucosal dissection; M: Intramucosal; SM: Submucosal.

Table 4 Comparison of short (< 90 min) and long (≥ 90 min) procedure time groups

	< 90 min, n = 26	≥ 90 min, n = 22	P value
Okayama University Hospital/other hospitals, n	15/11	5/17	0.01
Reconstruction route of gastric tube, n
Antethoracic/retrosternal/posterior mediastinal	6/11/9	3/4/15	0.06
Location of lesion, n
U/L/M	0/8/18	2/10/10	0.08
Median tumor size, mm (range)	13 (4-26)	15 (6-60)	0.06
Tumor depth, n
M/SM	23/3	17/5	0.30
Ulcerative findings positive, n	2	5	0.14

U: Upper; M: Medium; L: Lower; M: Intramucosal; SM: Submucosal.

Table 5 Multivariate analysis about risk factors for a long procedure time of endoscopic submucosal dissection for gastric tube cancer

	Risk ratio (95%CI)	P value
Other hospitals	3.18 (0.59-19.6)	NS
Posterior mediastinal route	3.18 (0.61-19.4)	NS
Location of lesion, U/M	2.12 (0.52-8.84)	NS
Median tumor size ≥ 20 mm	4.90 (1.09-29.6)	0.04

U: Upper; M: Medium; CI: Confidence interval.