Background: Radical surgery after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) may be excessive, since only 5-10% of patients have lymph node metastasis (LNM). This study investigated the suitability of the eCura system for determining the need for radical surgery after non-curative ESD.
Methods: We retrospectively investigated 343 patients who underwent non-curative ESD for EGC from 2006 to 2021 at a tertiary hospital in Korea. These patients were divided into surgery (n = 191) and observation (n = 152) groups based on whether they underwent additional surgery post-ESD. Each group was further classified into low-risk (eCura score 0-1), intermediate-risk (eCura score 2-4) and high-risk (eCura score 5-7). All patients were regularly followed-up at least annually after the initial treatment. The cumulative overall and recurrence-free survival rates were calculated for each category and compared between the surgery and observation groups.
Results: No significant differences in overall survival were found between the surgery and observation groups in low-risk (p = 0.168) and intermediate-risk patients (p = 0.306); however, high-risk patients had better 5-year overall survival rate in the surgery group than in the follow-up group (95.2% vs. 71.4%, p < 0.001). The 5-year recurrence-free survival rate was higher in the surgery group than in the observation group for low-risk (100% vs. 84.3%; p = 0.034), intermediate-risk (96.1% vs. 88.4%; p = 0.081) and high-risk patients (100% vs. 83.3%; p = 0.023).
Conclusions: Follow-up without additional surgery after non-curative ESD can be a reasonable option for low-risk and even intermediate-risk patients according to the eCura system. However, surgery is warranted for eCura high-risk patients.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1007/s00464-023-10324-2 | DOI Listing |
J Clin Med
November 2024
Unit of Hybrid Interventional Endoscopy, Department of Gastroenterology, Mediterraneo Hospital, 16675 Athens, Greece.
Resected rectal polyps with deep invasion into the submucosa (pT1b-sm2,3) or the muscle layer (pT2) are currently confronted with surgery due to non-curative resection. We evaluated the efficacy, safety, and locoregional control of adjuvant radiotherapy (RT) and/or chemotherapy (CT) following endoscopic KAR (knife-assisted resection) in patients with invasive early rectal cancers who are unwilling or unsuitable for additional surgical resection. Fifty-one patients with early rectal cancers, pT1b or pT2, underwent post-resection adjuvant RT and/or CT in 15 centers worldwide.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Institut de Cancérologie de Lorraine, 6 avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France; CRAN, CNRS, UMR 7039, Université de Lorraine, Vandœuvre-lès-Nancy, France.
Introduction And Importance: Chondrosarcoma is a tumor which arises from cartilage, and whose apparition can occur in any site. However, it remains rare in the larynx. Management depends on the grade and the stage of the tumor at the time of the presentation.
View Article and Find Full Text PDFBMC Gastroenterol
November 2024
Beijing Jishuitan Hospital, Capital Medical University, Beijing, 102208, China.
Objectives: The clinical decision-making regarding post hoc management of early colorectal cancer (CRC) patients who have undergone non-curative endoscopic resection (ER) remains a subject of debate. This systematic review and meta-analysis aims to compare the clinical outcomes between patients undergoing additional surgery and those receiving surveillance only.
Methods: A comprehensive literature search was conducted across three major medical databases: PubMed, Embase, and the Cochrane Library.
Oncologist
November 2024
Stanford Cancer Institute, Stanford University, Stanford, CA 94305, United States.
Treatment-oriented language is used by physicians to convey to patients that treatment is available for their cancer (eg, "our usual treatment for this is…," "we can treat this," "your cancer is still treatable"). For patients who have incurable cancer, especially for patients with a poor prognosis or who are at the end of life, it is important to understand how physicians conceptualize and use this "everyday" clinical language. We conducted a qualitative interview study with a multidisciplinary group of physicians (n = 30) who may care for patients with cancer at different points in their clinical course, from diagnosis to end of life.
View Article and Find Full Text PDFObjective: To investigate the time delay effect from initial diagnosis to endoscopic submucosal dissection on superficial esophageal squamous cell carcinoma curability, considering the preoperative invasion depth.
Methods: This study included superficial esophageal squamous cell carcinoma diagnosed as T1a-epithelial/lamina propria mucosa cancer (cEP/LPM; cancer invading up to the lamina propria mucosa) or cT1a-muscularis mucosa (MM)/T1b-submucosal cancer (cMM/SM1; cancer invading up to 200 µm into the submucosa) and treated using endoscopic submucosal dissection from January 2017 to December 2021. We compared curability in lesions treated within three months (early treatment group) versus those treated ≥7 months post-diagnosis (delayed treatment group).
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!