A0695 - Clinical Outcome of Endoscopic Submucosal Dissection for Early Gastric Cancer: A Retrospective Single Center Study

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Sera Satoi, MD

Memorial Sloan Kettering Cancer Center
New York, NY

Sera Satoi, MD, Makoto Nishimura, MD, Kana Chin, MD, Jacques C. Beauvais, MD, Mark Schattner, MD
Memorial Sloan Kettering Cancer Center, New York, NY

Introduction: Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer without the risk of lymph node metastasis. However, the outcomes in the United States are not well studied because of the low prevalence of gastric cancer. We aimed to assess the efficacy and safety of ESD for early gastric cancer in the United States.

Methods: We performed a single-center retrospective analysis of patients who underwent gastric ESD between June 2018 and December 2021. The main outcome measures were en-bloc resection rate, R0 (complete) resection rate, procedure time, tumor size, hospital length of stay (LOS), histology, and complication rate.

Results: In total, 46 patients were included. The median age was 71 years (range, 68.9-76.8 years). En-bloc and R0 resection rates were 94.5% and 81.8%, respectively. The median procedure time was 87.5 min (range, 69.3-118.8 min). The median tumor size was 26mm (range, 20-35 mm). The mean hospital length of stay was 1.87±1.38 days. The most common histologic type was pT1a (45.7%), followed by pT1b (26.1%), adenoma with low-grade dysplasia (13.0%), adenoma with high-grade dysplasia (10.9%), and neuroendocrine tumor (4.3%). There were 3 adverse events all of which were delayed bleeding and no perforations were reported.

Discussion: Our study showed that gastric ESD is a safe and effective method for superficial gastric neoplasia. ESD should be considered for patients with suitable lesions in the U.S.

Baseline characteristics	Age, y, median (IQR)		71 (68.9-76.8)
	Sex, men/women, n		30/16
	ASA class, n (%)	Ⅰ	0	0
		II	0	0
		Ⅲ	5	10.9
		Ⅳ	41	89.1
	Lesion site, n (%)	Antrum	10	21.7
		Body	13	28.3
		Greater curvature	1	2.2
		Lesser curvature	5	10.9
		Cardia	12	26.1
		Incisura angularis	5	10.9
	Type of injection, n (%)	Eleview	11	23.9
		Orise	35	76.1
	Type of primary knife for ESD, n (%)	Dual knife	29	63.0
		ProKnife	17	37.0
	Anesthesia, n (%)	Propofol	7	15.2
		General anesthesia	39	84.8
	Interventions before ESD, n (%)	Tattoo underneath lesion	6	13.0
		Scar underneath lesion	10	21.7
		Radiofrequency ablation	1	2.2
		ESD	4	8.7
		EMR	4	8.7
Outcomes	En bloc resection, n (%)		43	93.5
	R0 resection, n (%)		36	78.3
	Procedure time, min, median (IQR)		87.5 (69.3 - 118.8)
	Tumor size, mm, median (IQR)		26 (20 - 35)
	Length of hospital stay, d, mean ± SD		1.8 ± 1.4
	Histology, n (%)	Adenoma with LGD	6	13.0
		Adenoma with HGD	5	10.9
		pT1a	21	45.7
		pT1b	12	26.1
		Neuroendocrine tumor	2	4.3
	Adverse event, n (%)	Delayed bleeding	3	6.5
		Perforation	3	6.5
		Infection	0	0

Table: Baseline Characteristics and Outcomes of Gastric Endoscopic Submucosal Dissection
ESD=endoscopic submucosal dissection, EMR=endoscopic mucosal dissection, LGD=low-grade dysplasia, HGD=high-grade dysplasia

Disclosures:

Sera Satoi indicated no relevant financial relationships.

Makoto Nishimura: Boston Scientifics – Consultant. Lumendi – Consultant. Olympus – Consultant.

Kana Chin indicated no relevant financial relationships.

Jacques C. Beauvais indicated no relevant financial relationships.

Mark Schattner indicated no relevant financial relationships.

Sera Satoi, MD, Makoto Nishimura, MD, Kana Chin, MD, Jacques C. Beauvais, MD, Mark Schattner, MD. A0695 - Clinical Outcome of Endoscopic Submucosal Dissection for Early Gastric Cancer: A Retrospective Single Center Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.