Safety and Efficacy of Gastric Endoscopic Submucosal Dissection in a Non-academic Western Center.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-08-28 DOI:10.1007/s12029-025-01300-1

Sebastian Stefanovic, Rajko Knezevic, Maja Denkovski, Zoran Stanisic, Natasa Brglez Jurecic, Ljiljana Ljepovic, Marjan Gorenc, Andreja Hvalic, Davorin Dajcman, Dejan Urlep, Milan Stefanovic

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引用次数: 0

Abstract

Purpose: Endoscopic submucosal dissection (ESD) is a minimally invasive technique used to treat gastrointestinal neoplasms. Lower incidence of gastric lesions results in fewer studies of gastric ESD in the West. We aimed to show the safety and efficacy of gastric ESD in a non-academic center as compared to the available studies, while adhering to established international guidelines.

Methods: We retrospectively analyzed gastric ESDs in our center between June 2015 and December 2024. Included were precancerous lesions, early gastric cancers (EGCs), neuroendocrine neoplasias, and subepithelial lesions. Patient demographics, lesion characteristics, procedural details, adverse events, and treatment outcomes were analyzed. Primary study outcomes included rates of complete R0 resection (horizontal and vertical margins free of GI neoplasia on histopathology), curative resection in EGCs (R0 with no lymphovascular invasion, as defined by JGES criteria), and adverse events. Secondary outcomes were recurrence and diagnostic discrepancies.

Results: One hundred gastric ESDs were performed in 91 patients. Conversion to hybrid ESD/EMR was done in six cases. In one early case, ESD was aborted after intraprocedural perforation. R0 resection rates for all lesions were 91%, 100% for low-grade dysplasias, 100% for high-grade dysplasias, 80.9% for EGCs, and 100% for other indications. Curative resection was achieved in 78.7% of EGCs. Adverse events occurred in 11 (11%) cases. During the mean follow-up period of 21.8 ± 24.0 months, recurrence occurred in four of 73 patients with follow-up data (5.5%).

Conclusions: Our results demonstrate ESD as a safe and effective option for gastric lesions in non-academic Western centers.

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胃内镜下粘膜剥离术在西方非学术中心的安全性和有效性。

目的：内镜下粘膜下剥离术（ESD）是一种用于治疗胃肠道肿瘤的微创技术。由于胃病变发生率较低，西方对胃ESD的研究较少。我们的目的是在非学术中心与现有研究相比，显示胃ESD的安全性和有效性，同时遵守既定的国际指南。方法：回顾性分析本中心2015年6月至2024年12月的胃静电放电。包括癌前病变，早期胃癌（EGCs），神经内分泌肿瘤和上皮下病变。分析了患者人口统计学、病变特征、手术细节、不良事件和治疗结果。主要研究结果包括R0完全切除率（组织病理学上水平和垂直边缘无胃肠道肿瘤），EGCs的治愈性切除率（R0无淋巴血管侵犯，根据JGES标准定义）和不良事件。次要结局是复发和诊断差异。结果：91例患者行胃静电放电100次。在6例中进行了ESD/EMR混合转换。在一个早期病例中，ESD在术中穿孔后流产。所有病变的R0切除率为91%，低级别发育不良为100%，高级别发育不良为100%，EGCs为80.9%，其他适应症为100%。78.7%的EGCs获得根治性切除。11例（11%）发生不良事件。在平均21.8±24.0个月的随访期间，73例患者中有4例复发（5.5%）。结论：我们的研究结果表明，在西方非学术中心，ESD是一种安全有效的治疗胃病变的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.