Endoscopic submucosal dissection in a population with a low incidence of gastric cancer

Česká verze

Authors: Ondřej Urban ¹ ; Přemysl Falt ¹ ; Vincent Dansou Zoundjiekpon ¹ ; Daniela Škanderová ² ; Daniela Kurfürstová ² ; Dušan Klos ³
Authors place of work: II. interní klinika – gastroenterologická a geriatrická LF UP a FN Olomouc 2 Ústav klinické a molekulární patologie LF UP a FN Olomouc 3 I. chirurgická klinika LF UP a FN Olomouc ¹
Published in the journal: Gastroent Hepatol 2024; 78(3): 236-241
Category: Původní práce
doi: https://doi.org/10.48095/ccgh2024236

Summary

Introduction: Gastric cancer is a serious disease with a decreasing incidence. In the treatment of its early stages, endoscopic methods, especially endoscopic submucosal dissection (ESD), are used significantly. Methods: We present the results of 64 consecutive ESD gastric lesions. We performed ESD using a conventional technique with a circular incision followed by submucosal dissection with the DualKnife tool. In cases of carcinomas, we assessed the outcome of ESD according to the eCura scoring system. Results: We achieved en bloc resection in 88% and R0 resection in 72%. Significant bleeding occurred in 8% and perforation in 3%; we managed all complications conservatively, where the lethal rate was zero. Of the 58 ESD neoplastic lesions, 42 (72%) were curative. We considered 6 (10%) patients for surgery after ESD, and it was performed in 2 (3%). Conclusion: In the conditions of a country with a low incidence of gastric cancer, we consider ESD to be a safe method with significant curative potential.

Keywords:

gastric cancer – endoscopic submucosal dissection – curative resection

Zdroje

1. Sung H, Ferlay J, Siegel RL et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71 (3): 209–249. doi: 10.3322/caac.21660.

2. Morgan E, Arnold M, Camargo MC et al. The current and future incidence and mortality of gastric cancer in 185 countries, 2020–40: a population-based modelling study. EClinicalMedicine 2022; 47: 101404. doi: 10.1016/j.eclinm. 2022.101404.

3. Krejčí D, Mužík J, Dušek L. Současné epidemiologické trendy novotvarů v České republice. Novotvary 2019–2021 ČR. [online]. Dostupné z: https: //www.uzis.cz/res/f/008447/ novotvary2019-2021.pdf.

4. Majek O, Krejci D, Pavlik T et al. Epidemiology of gastric cancers. In: Obermannova R. Multidisciplinary approach to oesophageal and gastric cancer. Praha: Current Media s. r. o. 2018.

5. Tada M. 13th International Gastric Cancer Congress. 2019 [online]. Dostupné z: https: //www.linkos.cz/lekar-a-multidisciplinarni-tym/celozivotni-vzdelavani/kongresy/kongresovy-kalendar/13-th-international-gastric-cancer- congress/.

6. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018 (5th edition). Gastric Cancer 2021; 24 (1): 1–21. doi: 10.1007/s10120-020-01042-y.

7. Smyth EC, Verheij M, Allum W et al. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2016; 27 (Suppl 5): 38–49. doi: 10.1093/annonc/ mdw350.

8. Pimentel-Nunes P, Libanio D, Bastiaansen BAJ et al. Endoscopic submucosal dissection for superficial gastrointestinal lesions. European Society of Gastrointestinal Endoscopy (ESGE) guideline – update 2022. Endoscopy 2022; 54 (6): 591–622. doi: 10.1055/a-1811-7025.

9. Ajani JA, D‘Amico TA, Almhanna K et al. Gastric cancer, version 3.2016, NCCN clinical practice clinical guidelines in oncology. J Natl Comp Canc Netw 2016; 14 (10): 1286–1312. doi: 10.6004/jnccn.2016.0137.

10. Al-Haddad MA, Elhanafi SE, Forbes N et al. American Society for Gastrointestinal Endoscopy guideline on endoscopic submucosal dissection for the management of early esophageal and gastric cancers: methodology and review of evidence. Gastrointest Endosc 2023; 98 (3): 285.e38––305.e38. doi: 10.1016/j.gie.2023.03.030.

11. Oguro Y, Fukutomi H, Suzuki S et al. Experience of polypectomy for elevated early gastric cancer. Prog Dig Endosc 1974; 5: 77–80.

12. Gotoda T, Kondo H, Ono H et al. A new endoscopic mucosal resection procedure using an insulation-tipped electrosurgical knife for rectal flat lesions: report of two cases. Gastrointest Endosc 1999; 50 (4): 560–563. doi: 10.1016/s0016-5107 (99) 70084-2.

13. Ohkuwa M, Hosokawa K, Boku N et al. New endoscopic treatment for intramucosal gastric tumors using an insulated-tip diathermic knife. Endoscopy 2001; 33 (3): 221–226. doi: 10.1055/s-2001-12805.

14. Akintoye E, Obaitan I, Muthusamy A et al. Endoscopic submucosal dissection of gastric tumors: a systematic review and meta-analysis. World J Gastrointest Endosc 2016; 8 (15): 517–532. doi: 10.4253/wjge.v8.i15.517.

15. Urban O, Fojtík P, Falt P et al. Krátkodobé výsledky léčby povrchových neoplastických lézí žaludku endoskopickou submukózní disekcí (ESD). Gastroent Hepatol 2015; 69 (1): 65–69. doi: 10.14735/amgh201565.

16. Bhandari P, Abdelrahim M, Asma AA et al. Predictors of long term outcomes of endoscopic submucosal dissection of early gastric neoplasia in the West: a multicenter study. Endoscopy 2023; 55 (10): 898–906. doi: 10.1055/a-2100-2258.

17. Probst A, Pommer B, Golger D et al. Endoscopic submucosal dissection in gastric neoplasia – experience from a European center. Endoscopy 2010; 42 (12): 1037–1044. doi: 10.1055/s-0030-1255668.

18. Oda I, Saito D, Tada M et al. A multicenter retrospective study of endoscopic resection for early gastric cancer. Gastric Cancer 2006; 9 (4): 262–270. doi: 10.1007/s10120-006-0389-0.

19. Schlemper RJ, Itabashi M, Kato Y et al. Differences in diagnostic criteria for gastric carcinoma between Japanese and western pathologists. Lancet 1997; 349 (9067): 1725–1729. doi: 10.1016/S0140-6736 (96) 12249-2.

20. Lee BI, Kim BW, Kim HK, Choi H et al. Routine mucosal closure with a detachable snare and clips after endoscopic submucosal dissection for gastric epithelial neoplasms: a randomized controlled trial. Gut Liver 2011; 5 (4): 454–459. doi: 10.5009/gnl.2011.5.4.454.

21. Cyrany J, Balihar K, Falt P et al. Gastroskopie – standardy kvality České gastroenterologické společnosti ČLS JEP. Gastroenterol Hepatol 2022; 76 (3): 194–211. doi: 10.48095/ccgh2022 194.

22. Park EH, Kang KT, Kim BH et al. The histologic discrepancy before and after endoscopic submucosal dissection of gastric adenoma and early gastric cancer. Korean J Gastrointest Endosc 2007; 34: 125–131.

23. Hatta W, Gotoda T, Oyama T et al. A scoring system to stratify curability after endoscopic submucosal dissection for early gastric cancer: “ecura system”. Am J Gastroenterol 2017; 112 (6): 874–881. doi: 10.1038/ajg.2017.95.

24. Katai H, Ishikawa T, Akazawa K et al. Five-year survival analysis of surgically resected gastric cancer cases in Japan: a retrospective analysis of more than 100,000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001–2007). Gastric Cancer 2018; 21 (1): 144–154. doi: 10.1007/s10120-017-0716-7.

25. Cho JH, Cha SW, Kim HG et al. Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a comparison study to surgery using propensity score-matched analysis. Surg Endosc 2016; 30 (9): 3762–3773. doi: 10.1007/s00464-015-4672-1.

26. Shin DW, Hwang HY, Jeon SW. Comparison of endoscopic submucosal dissection and surgery for differentiated type early gastric cancer within the expanded criteria. Clin Endosc 2017; 50 (2): 170–178. doi: 10.5946/ce.2016.017.

ORCID autorů

O. Urban 0000-0002-6705-7912,

P. Falt 0000-0001-8843-4716,

V. D. Zoundjiekpon 0000-0002-5673-3276

D. Skanderová 0009-0008-0641-5078,

D. Kurfürstová 0000-0002-3175-3131,

D. Klos 0000-0002-3097-4418.

Doručeno/Submitted: 18. 3. 2024

Přijato/Accepted: 5. 5. 2024

prof. MUDr. Ondřej Urban, Ph.D.

II. interní klinika – gastroenterologická a geriatrická

LF UP a FN Olomouc