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©The Author(s) 2021.
World J Gastroenterol. Mar 21, 2021; 27(11): 1043-1054
Published online Mar 21, 2021. doi: 10.3748/wjg.v27.i11.1043
Published online Mar 21, 2021. doi: 10.3748/wjg.v27.i11.1043
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) |
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) |
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 |
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 |
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 |
- Citation: Satomi T, Kawano S, Inaba T, Nakagawa M, Mouri H, Yoshioka M, Tanaka S, Toyokawa T, Kobayashi S, Tanaka T, Kanzaki H, Iwamuro M, Kawahara Y, Okada H. Efficacy and safety of endoscopic submucosal dissection for gastric tube cancer: A multicenter retrospective study. World J Gastroenterol 2021; 27(11): 1043-1054
- URL: https://www.wjgnet.com/1007-9327/full/v27/i11/1043.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i11.1043