Endoscopy 2019; 51(04): S40
DOI: 10.1055/s-0039-1681287
ESGE Days 2019 oral presentations
Friday, April 5, 2019 11:00 – 13:00: ESD stomach 1 Club A
Georg Thieme Verlag KG Stuttgart · New York

LONG-TERM OUTCOME OF EARLY GASTRIC CANCER WITH LATERAL MARGIN POSITIVE AFTER ENDOSCOPIC RESECTION

H Kim
1   Internal Medicine, Inha University Hospital, Incheon, Korea, Republic of
,
DH Yang
1   Internal Medicine, Inha University Hospital, Incheon, Korea, Republic of
,
BW Bang
1   Internal Medicine, Inha University Hospital, Incheon, Korea, Republic of
,
KS Kwon
1   Internal Medicine, Inha University Hospital, Incheon, Korea, Republic of
,
YW Shin
1   Internal Medicine, Inha University Hospital, Incheon, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

The positive lateral margin after endoscopic resection (ER) of early gastric cancer (EGC), additional surgery or endoscopic submucosal dissection (ESD) are recommended. However, the additional surgery often difficult due to advanced age or patient's comorbid conditions. The aims of this study is to investigate of long term outcome in patients with positive lateral margin after ER.

Methods:

We analyzed retrospectively 103 patients with positive lateral margin after ER.

Results:

Of the 103 patients, 27 patients (26.4%) underwent re-do ESD in 17 patients and additional surgery in 10 patients within 3months. And 76 patients (73.6%) were observed under close surveillance. Median duration of follow-up period was 45.7 (6 – 132) months. Recurrence rates of early re-treatment group (3.7%, n = 1/27) was lower than surveillance group (18.4%, n = 14/76; p = 0.05). five-year survival rates not significantly different between the two groups, at 100%, 97.4% respectively. In close surveillance periods, 14 patients were confirmed to local recurrence by follow-up biopsy, then delayed re-treatment was performed. (7 patients in re-do ESD, 5 patients in surgery, mean time after initial ER = 27.5months) Finally, a total of 24 patients were treated with re-ESD, and 17 patients were treated with additional surgery. Among these two groups, there were no significant difference in recurrence rates (8.3% vs. 0%) and five-year survival rates (both 100%). However, adverse events that related to treatment was more frequent in additional surgical group (2 ileus, 1 umbilical hernia).

Conclusions:

Re-ESD which have a similar efficacy and a better quality of life, compared to additional surgery is a favorable option for control of recurrence or residual EGCs.