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Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study

BACKGROUND: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used techniques for the treatment of gastric epithelial dysplasia. Previous studies have compared the clinical outcome of endoscopic resection for early gastric cancer, but few studies have focused o...

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Autores principales: Back, Min Kyung, Moon, Hee Seok, Kwon, In Sun, Park, Jae Ho, Kim, Ju Seok, Kang, Sun Hyung, Sung, Jae Kyu, Lee, Eaum Seok, Kim, Seok Hyun, Lee, Byung Seok, Jeong, Hyun Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216613/
https://www.ncbi.nlm.nih.gov/pubmed/32397967
http://dx.doi.org/10.1186/s12876-020-01293-0
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author Back, Min Kyung
Moon, Hee Seok
Kwon, In Sun
Park, Jae Ho
Kim, Ju Seok
Kang, Sun Hyung
Sung, Jae Kyu
Lee, Eaum Seok
Kim, Seok Hyun
Lee, Byung Seok
Jeong, Hyun Yong
author_facet Back, Min Kyung
Moon, Hee Seok
Kwon, In Sun
Park, Jae Ho
Kim, Ju Seok
Kang, Sun Hyung
Sung, Jae Kyu
Lee, Eaum Seok
Kim, Seok Hyun
Lee, Byung Seok
Jeong, Hyun Yong
author_sort Back, Min Kyung
collection PubMed
description BACKGROUND: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used techniques for the treatment of gastric epithelial dysplasia. Previous studies have compared the clinical outcome of endoscopic resection for early gastric cancer, but few studies have focused on gastric dysplasia alone. This study aimed to evaluate the long-term prognosis following endoscopic procedures for gastric epithelial dysplasia, investigate differences in local recurrence rates according to the treatment modality, and identify risk factors associated with local recurrence. METHODS: In this retrospective study, local recurrence rates and risk factors associated with local recurrence were compared between 599 patients who underwent EMR and 306 who underwent ESD for gastric epithelial dysplasia from January 2011 to December 2015. RESULTS: The en bloc resection rate (32.2% vs. 100%, p < 0.001) and complete resection rate (94.8% vs. 99.0%, p = 0.003) were significantly lower in the EMR group than in the ESD group. The local recurrence rate was significantly lower in the ESD group (1.3%) than in the EMR group (4.2%; p = 0.026). There was a significantly increased risk of local recurrence, regardless of lesion location or histologic grade, in patients with lesions > 2 cm (p = 0.002) or red in color (p = 0.03). The ESD group had a significantly lower local recurrence rate, with a higher complete resection rate, than that in the EMR group (p < 0.05). In the case of recurrence after endoscopic resection, most of the recurred lesions were removed through additional endoscopic procedures; there was no difference between the two groups (p = 0.153). CONCLUSIONS: The complete resection rate was significantly higher, and the local recurrence rate was significantly lower, in patients with gastric epithelial dysplasia treated with ESD. Therefore, ESD should be considered the preferred treatment in patients with lesions > 2 cm or showing redness due to an increased risk of local recurrence and EMR may be possible for low-grade dysplasia that is less than 2 cm without surface changes such as redness, depression and nodularity.
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spelling pubmed-72166132020-05-18 Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study Back, Min Kyung Moon, Hee Seok Kwon, In Sun Park, Jae Ho Kim, Ju Seok Kang, Sun Hyung Sung, Jae Kyu Lee, Eaum Seok Kim, Seok Hyun Lee, Byung Seok Jeong, Hyun Yong BMC Gastroenterol Research Article BACKGROUND: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used techniques for the treatment of gastric epithelial dysplasia. Previous studies have compared the clinical outcome of endoscopic resection for early gastric cancer, but few studies have focused on gastric dysplasia alone. This study aimed to evaluate the long-term prognosis following endoscopic procedures for gastric epithelial dysplasia, investigate differences in local recurrence rates according to the treatment modality, and identify risk factors associated with local recurrence. METHODS: In this retrospective study, local recurrence rates and risk factors associated with local recurrence were compared between 599 patients who underwent EMR and 306 who underwent ESD for gastric epithelial dysplasia from January 2011 to December 2015. RESULTS: The en bloc resection rate (32.2% vs. 100%, p < 0.001) and complete resection rate (94.8% vs. 99.0%, p = 0.003) were significantly lower in the EMR group than in the ESD group. The local recurrence rate was significantly lower in the ESD group (1.3%) than in the EMR group (4.2%; p = 0.026). There was a significantly increased risk of local recurrence, regardless of lesion location or histologic grade, in patients with lesions > 2 cm (p = 0.002) or red in color (p = 0.03). The ESD group had a significantly lower local recurrence rate, with a higher complete resection rate, than that in the EMR group (p < 0.05). In the case of recurrence after endoscopic resection, most of the recurred lesions were removed through additional endoscopic procedures; there was no difference between the two groups (p = 0.153). CONCLUSIONS: The complete resection rate was significantly higher, and the local recurrence rate was significantly lower, in patients with gastric epithelial dysplasia treated with ESD. Therefore, ESD should be considered the preferred treatment in patients with lesions > 2 cm or showing redness due to an increased risk of local recurrence and EMR may be possible for low-grade dysplasia that is less than 2 cm without surface changes such as redness, depression and nodularity. BioMed Central 2020-05-12 /pmc/articles/PMC7216613/ /pubmed/32397967 http://dx.doi.org/10.1186/s12876-020-01293-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Back, Min Kyung
Moon, Hee Seok
Kwon, In Sun
Park, Jae Ho
Kim, Ju Seok
Kang, Sun Hyung
Sung, Jae Kyu
Lee, Eaum Seok
Kim, Seok Hyun
Lee, Byung Seok
Jeong, Hyun Yong
Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study
title Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study
title_full Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study
title_fullStr Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study
title_full_unstemmed Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study
title_short Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study
title_sort analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216613/
https://www.ncbi.nlm.nih.gov/pubmed/32397967
http://dx.doi.org/10.1186/s12876-020-01293-0
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