Long-term follow-up after endoscopic resection of gastric superficial neoplastic lesions in Portugal

• Type: Article in International Scientific Journal
• Date: 2014

Authors

Pedro Pimentel-Nunes (Author) FMUP; Mourao, F (Author) Other; Veloso, N (Author) Other; Afonso, LP (Author) Other; Jacome, M (Author) Other; Moreira Dias, L (Author) Other; Mario Dinis Ribeiro (Author) FMUP

Journal

Title: Endoscopy

Vol. 46

Pages: 933-940

ISSN: 0013-726X

Publisher: Thieme

Indexing

ISI Web of Knowledge - 67 Citations

Scopus - 78 Citations

Other information

Authenticus ID: P-00A-1SN

DOI: 10.1055/s-0034-1377348

Abstract (EN): Background and study aims: Although endoscopic resection for the treatment of gastric superficial neoplastic lesions is an established first-line treatment in Eastern countries, its role has yet to be considered in Western guidelines, mostly due to a lack of long-term studies. The aim of this study was to describe long-term outcomes for endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in the treatment of gastric neoplasias in Portugal. Patients and methods: This was a single-center, retrospective, cohort study between March 2003 and April 2013. A total of 162 consecutive patients with 195 gastric superficial neoplasias underwent EMR (n=54) or ESD (n=141) and were followed up for a median of 3.2 years. Results: Resection was feasible in 97%, with en bloc and R0 resection rates of 85% (94% ESD vs. 61% EMR; P=0.001) and 81% (91% ESD vs. 54% EMR; P<0.001), respectively. The recurrence rate was 7%, and recurrence was associated with Rx/R1 resection irrespective of resection technique (OR 5.8; 95% confidence interval 3.9-8.8). The long-term curative resection rate was 86% after one procedure and 91% after two procedures. Adverse events were observed in 13% of cases: 8% bleeding and 2% of perforations (EMR=ESD). Surgery was performed in 7%: 6% after noncurative endoscopic resection and 1% due to complications. Metachronous lesion detection rate was 1%-1.5% per patient year. Cancer-specific survival rate was 100% at follow-up. Conclusions: For the first time in a Western country, results are reported to be similar to those in Eastern countries. Endoscopic resection, particularly ESD, is a highly effective treatment for gastric superficial lesions, without compromising cancer survival. Endoscopic resection should also be considered as first-line treatment for gastric neoplasias in Western countries.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8