Sebastian Stefanovic, Rajko Knezevic, Maja Denkovski, Zoran Stanisic, Natasa Brglez Jurecic, Ljiljana Ljepovic, Marjan Gorenc, Andreja Hvalic, Davorin Dajcman, Dejan Urlep, Milan Stefanovic
{"title":"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。","authors":"Sebastian Stefanovic, Rajko Knezevic, Maja Denkovski, Zoran Stanisic, Natasa Brglez Jurecic, Ljiljana Ljepovic, Marjan Gorenc, Andreja Hvalic, Davorin Dajcman, Dejan Urlep, Milan Stefanovic","doi":"10.1007/s12029-025-01300-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>Our results demonstrate ESD as a safe and effective option for gastric lesions in non-academic Western centers.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"181"},"PeriodicalIF":1.6000,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Safety and Efficacy of Gastric Endoscopic Submucosal Dissection in a Non-academic Western Center.\",\"authors\":\"Sebastian Stefanovic, Rajko Knezevic, Maja Denkovski, Zoran Stanisic, Natasa Brglez Jurecic, Ljiljana Ljepovic, Marjan Gorenc, Andreja Hvalic, Davorin Dajcman, Dejan Urlep, Milan Stefanovic\",\"doi\":\"10.1007/s12029-025-01300-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>Our results demonstrate ESD as a safe and effective option for gastric lesions in non-academic Western centers.</p>\",\"PeriodicalId\":15895,\"journal\":{\"name\":\"Journal of Gastrointestinal Cancer\",\"volume\":\"56 1\",\"pages\":\"181\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-08-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Gastrointestinal Cancer\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12029-025-01300-1\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12029-025-01300-1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Safety and Efficacy of Gastric Endoscopic Submucosal Dissection in a Non-academic Western Center.
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.
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.
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