Endoscopy 2021; 53(S 01): S52
DOI: 10.1055/s-0041-1724384
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Friday, 26 March 2021 14:00 – 14:45 Challenges in gastric ESD Room 5

Endoscopic Submucosal Dissection: Recurrence Among R0 Resections… How to Explain?

M Rodríguez-Carrasco
1   Portuguese Oncology Institute of Porto, Gastroenterology Department, Porto, Portugal
,
D Libânio
1   Portuguese Oncology Institute of Porto, Gastroenterology Department, Porto, Portugal
2   Faculty of Medicine, University of Porto, MEDCIDS - Department of Community Medicine, Health Information and Decision, Porto, Portugal
,
P Pimentel-Nunes
1   Portuguese Oncology Institute of Porto, Gastroenterology Department, Porto, Portugal
2   Faculty of Medicine, University of Porto, MEDCIDS - Department of Community Medicine, Health Information and Decision, Porto, Portugal
3   Faculty of Medicine, University of Porto, Department of Surgery and Physiology, Porto, Portugal
,
LP Afonso
4   Portuguese Oncology Institute of Porto, Pathology Department, Porto, Portugal
,
P Monterio
4   Portuguese Oncology Institute of Porto, Pathology Department, Porto, Portugal
,
M Dinis-Ribeiro
1   Portuguese Oncology Institute of Porto, Gastroenterology Department, Porto, Portugal
2   Faculty of Medicine, University of Porto, MEDCIDS - Department of Community Medicine, Health Information and Decision, Porto, Portugal
› Author Affiliations
› Further Information
Also available at
 
 

    Aims Endoscopic submucosal dissection (ESD) is a well-established procedure for the treatment of early gastric cancer in Eastern countries. However, this technique has not been yet widely implemented in western centres due to its higher risk of complications and worse outcomes compared to expert-Eastern centres. We aimed to assess safety, oncological outcomes of ESD, and risk factors for local recurrence.

    Methods Data from gastric ESD of epithelial neoplastic lesions performed in our centre between January/2005-May/2020 was retrospectively analysed.

    Results 632 gastric ESD were performed in 528 patients (57 % men, mean age 68 years). Fifty-two percent of the lesions had distal location, 69 % with ≤ 20 mm in size, and 46 % 0-II type with depressed component. En-bloc resection was achieved in 613 procedures (97 %), R0 was obtained in 587 (92 %). Curative criteria were met in 509 resections (80.5 %). Six percent of patients experienced bleeding (0.3 % intraprocedural) and 1.4 % perforation (0.8 % intraprocedural and 0.6 % delayed). The majority of complications were endoscopically managed but 2 patients (0.3 %) had fatal delayed adverse event resulted in death. Local recurrence was detected in 17 cases (2.7 %), 65 % (n = 11) among those considered R0 resection (27.3 % low-grade dysplasia, 9.1 % high-grade dysplasia, 63.6 % intramucosal well-differentiated adenocarcinoma). Piecemeal resection and R1/Rx resection were the only factors significantly associated with the occurrence of recurrence in the univariate analysis (p=0.06 and p<0.01 respectively).

    Conclusions Gastric ESD is an effective and safe procedure for the treatment of epithelial neoplastic lesions. More studies are necessary to identify possible risk factors for local-recurrence, particularly in cases with previous R0 resections.

    Citation: Rodríguez-Carrasco M, Libânio D, Pimentel-Nunes P et al. OP125 ENDOSCOPIC SUBMUCOSAL DISSECTION: RECURRENCE AMONG R0 RESECTIONS… HOW TO EXPLAIN?. Endoscopy 2021; 53: S52.


    #

    Publication History

    Article published online:
    19 March 2021

    © 2021. European Society of Gastrointestinal Endoscopy. All rights reserved.

    Georg Thieme Verlag KG
    Rüdigerstraße 14, 70469 Stuttgart, Germany