Journal of Hebei Medical University ›› 2022, Vol. 43 ›› Issue (7): 787-791.doi: 10.3969/j.issn.1007-3205.2022.07.009

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Analysis of risk factors related to non-curable resection of early gastric cancer by endoscopic submucosal dissection

  

  1. Department of Gastroenterology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

  • Online:2022-07-25 Published:2022-07-26

Abstract: Objective To evaluate the efficacy and safety of endoscopic submucosal dissection(ESD) in the treatment of early gastric cancer(EGC), and to understand the related risk factors and prognosis of non-curative resection(nCuR). 
Methods The relevant clinical data and follow-up prognosis of EGC patients who received ESD were collected, and they were divided into curative resection(CuR) and nCuR groups. 
Results Among the 99 patients included,the number of cases aged 40 years or older increased significantly, and reached a peak around the age of 65. The diameter of the lesion was (2.32±1.73) cm, and the lesions were mainly located in the upper third of the stomach(70.7%). En-bloc resection was performed in 99 cases(100.0%), complete resection in 79 cases(79.8%), and curative resection in 71 cases(71.7%). There were statistical differences in lesion diameter, postoperative pathology and depth of invasion in the CuR and nCuR groups. Logistic regression analysis showed that postoperative pathology and depth of invasion were risk factors for nCuR(P<0.05).According to the follow-up after ESD, among the patients who underwent stratification of eCura scoring system, 8 had additional surgery, 3 were in the low-risk group, and 5 were in the moderate-risk group; 1 patient who was found to have local cancer residue and regional lymph node metastasis was classified as moderate risk. 
Conclusion In preoperative evaluation of EGC patients, more attention should be paid to the judgment of lesion diameter, preoperative pathological type and depth of invasion, and the indication standard should be fully understood. The treatment plan for patients with nCuR may refer to the eCura scoring system. 

Key words: stomach neoplasms, endoscopic mucosal resection, non-curative resection