Oncologic Outcomes of Endoscopic Resection for Early Gastric Cancer

Year 2017, Volume: 3 Issue: 1, 8 - 15, 30.03.2017

Cemil Bilir , Hakan Cinemre

Abstract

Gastric
cancer is the fifth most common cancer in the world, and about one million new
cases develop globally each year. Early Gastric Cancer (EGC) is a stage that
tumor invades gastric mucosa or submucosa with or without involvement of the
lymph nodes (LN). Endoscopic resection techniques
are endoscopic mucosal resection (EMR) and endoscopic submucosal dissection
(ESD), latter of which is more popular now. Gastrectomy is the standard choice
of treatment but, is highly invasive that requires longer stay at hospital, with
higher costs and complication rates, especially at the anastomotic site. EMR was
used more frequently before the development of ESD but, now give its popularity
to ESD and EMR depends on the region and experience of the center. EMR is more
convenient method for smaller lesions, associated with lower bleeding risk and
shorter duration of operation compared to ESD. On the other hand, ESD has lower
en-block resection rates and recurrence rates compared to EMR. In this review,
we analyzed over than 10.000 patients’ oncologic outcomes including overall
survival, disease free survival and recurrence rates.  In conclusion, many newly diagnosed gastric cancer
patients are seeking micro-invasive treatment modalities around the World for
their early stage cancers. Endoscopic submucosal resection and endoscopic
mucosal resection are safe and convenient procedures and had comparable
oncologic outcomes with surgery. Additionally, these techniques can easily be
used in patients who are not surgical candidates. 

Keywords

Early gastric cancer, endoscopic resection

References

• Engin H, Bilir C, Ustündağ Y. MELD-sodium score and its prognostic value in malignancy-related ascites of pancreatic and gastric cancer. Support Care Cancer. 2013 Apr;21(4):1153-6.
• 2Roviello F, Rossi S, Marrelli D, Pedrazzani C, Corso G, VindigniC, Morgagni P, Saragoni L, de Manzoni G, Tomezzoli A. Numberof lymphnodemetastasesanditsprognosticsignificance in earlygastriccancer: a multicenterItalianstudy. J SurgOncol 2006; 94: 275-280
• 3 Sun K, Chen S, Ye J, Wu H, Peng J, He Y, Xu J. Endoscopic resection versus surgery for early gastric cancer: a systematic review and meta-analysis. Dig Endosc 2016;28: 513-25
• 4 Gotoda T, Yanagisawa A, Sasako M, Ono H, Nakanishi Y, Shimoda T, Kato Y. Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 2000; 3: 219–25
• 5 Soetikno R, Kaltenbach T, Yeh R, Gotoda T. Endoscopic mucosal resection for early cancers of the upper gastrointestinal tract. J ClinOncol. 2005; 23: 4490–4498
• 6 Deprez PH, Bergman JJ, Meisner S, Ponchon T, Repici A, Dinis-Ribeiro M, Haringsma J. Current practice with endoscopic submucosal dissection in Europe: position statement from a panel of experts. Endoscopy 2010;42:853–858
• 7 Cao Y, Liao C, Tan A, Gao Y, Mo Z, Gao F. Meta-analysis of endoscopic submucosal dissection vs. endoscopic mucosal resection for tumors of the gastrointestinal tract. Endoscopy 2009;41:751–757
• 8 Balmadrid B and Hwang J.H. Endoscopic resection of gastric and esophageal cancer. Gastroenterol Rep (Oxf). 2015; 3: 330–338
• 9 Yamashita T, Zeniya A, Ishii H, Tsuji T, Tsuda S, Nakane K, Komatsu M. Endoscopic mucosal resection using a cap-fitted panendoscope and endoscopic submucosal dissection as optimal endoscopic procedures for superficial esophageal carcinoma. SurgEndosc 2011;25:2541–2546
• 10 Yamasaki M, Kume K, Yoshikawa I et al. A novel method of endoscopic submucosal dissection with blunt abrasion by submucosal injection of sodium carboxymethylcellulose: an animal preliminary study. GastrointestEndosc2006;64:958–965.
• Noguchi Y, Yoshikawa T, Tsuburaya A, Motohashi H, Karpeh MS, Brennan MF.Is gastric carcinoma different between Japan and the United States? Cancer 2000; 89: 2237.
• 12 Lee HJ, Yang HK, Ahn YO. Gastric cancer in Korea.Gastric Cancer 2002;5:177
• 13 Maehara Y, Orita H, Okuyama T, Moriguchi S, Tsujitani S, Korenaga D, Sugimachi K. Predictors of lymph node metastasis in early gastric cancer. Br J Surg 1992; 79: 245.
• 14 Schlemper RJ, Itabashi M, Kato Y, Iwashita A, Kato Y, Koike M, Lewin KJ, Riddell RH, Shimoda T, Sipponen P, Stolte M, Watanabe H. Differences in diagnostic criteria for gastric carcinoma between Japanese and western pathologists. Lancet 1997; 349: 1725.
• 15 Japanese Classification of Gastric Carcinoma - 2nd English Edition. Gastric Cancer 1998; 1:10.
• 16 Hasuo T, Semba S, Li D, Shirasaka D, Aoyama N, Yokozaki H. Assessment of microsatellite instability status for the prediction of metachronous recurrence after initial endoscopic submucosal dissection for early gastric cancer. Br J Cancer 2007; 96:89.
• 17 Zhu C, Ren C, Han J, Ding Y, Du J, Dai N, Dai J, Ma H, Hu Z, Shen H, Xu Y, Jin G. A five-microRNA panel in plasma was identified as potential biomarker for early detection of gastric cancer. Br J Cancer 2014; 110:2291.
• 18 Ballantyne KC, Morris DL, Jones JA, Gregson RH, Hardcastle JD.Accuracy of identification of early gastric cancer.Br J Surg 1987; 74:618
• 19 Fuccio L, Zagari RM, Eusebi LH, Laterza L, Cennamo V, Ceroni L, Grilli D, Bazzoli F. Meta-analysis: can Helicobacter pylori eradication treatment reduce the risk for gastric cancer? Ann Intern Med 2009; 151:121.
• 20 Choi J, Kim SG, Im JP, Kim JS, Jung HC, Song IS.Comparison of endoscopic ultrasonography and conventional endoscopy for prediction of depth of tumor invasion in early gastric cancer. Endoscopy 2010; 42:705.
• Min YW, Min BH, Lee JH, Kim JJ.Endoscopic treatment for early gastric cancer. World J Gastroenterol 2014; 20: 4566.
• 22 Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin 2012; 62: 10
• 23 Wanebo HJ, Kennedy BJ, Chmiel J, Steele G Jr, Winchester D, Osteen R. Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg 1993; 218: 583.
• 24 Chen K, Xu XW, Zhang RC, PanY,Wu D, Mou YP.Systematicreviewand meta-analysis of laparoscopy-assistedandopen total gastrectomyforgastriccancer. World J Gastroenterol2013; 19: 5365–5376.
• 25 Shen H, Shan C, Liu S, Qiu M. Laparoscopy-assistedversusopen total gastrectomyforgastriccancer: a meta-analysis.J LaparoendoscAdvSurgTech A2013; 23: 832–840.
• 26 Hiki N, Sano T, Fukunaga T, Ohyama S, Tokunaga M, Yamaguchi T. Survival benefit of pylorus-preserving gastrectomy in early gastric cancer.J Am CollSurg2009; 209:297-301.
• 27 Morita S, Katai H, SakaM, Fukagawa T, Sano T, Sasako M. Outcome of pylorus-preserving gastrectomy for early gastric cancer.Br J Surg 2008;95: 1131
• 28 Folli S, Dente M, Dell'Amore D, Gaudio M, Nanni O, Saragoni L, Vio A. Early gastric cancer: prognostic factors in 223 patients. Br J Surg 1995;82:952.
• 29 Kitano S, Shiraishi N, Uyama I,Sugihara K, Tanigawa N and the Japanese Laparoscopic Surgery Study Group. A Multicenter Study on Oncologic Outcome of Laparoscopic Gastrectomy for Early Cancer in Japan. Ann Surg 2007; 245: 68–72.
• 30 Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, Cho GS, Kim CY, Yang HK, Park DJ, Song KY, Lee SI, Ryu SY, Lee JH, Lee HJ; Korean Laparo-endoscopic Gastrointestinal Surgery Study (KLASS) Group. Decreased Morbidity of Laparoscopic Distal Gastrectomy Compared With Open Distal Gastrectomy for Stage I Gastric Cancer: Short-term Outcomes From a Multicenter Randomized Controlled Trial (KLASS-01).Ann Surg2016;263: 28-35.
• Lee JH, Nam BH, Ryu KW, Ryu SY, Park YK, Kim S, Kim YW. Comparison of outcomes after laparoscopy-assisted and open total gastrectomy for early gastric cancer. Br J Surg2015;102: 1500-5
• 32 Tada M, Murakami A, Karita M, Yanai H, Okita K. Endoscopicresection ofearlygastriccancer. Endoscopy 1993;25:445–50.
• 33 Watanabe K, Ogata S, Kawazoe S, Watanabe K, Koyama T, Kajiwara T, Shimoda Y, Takase Y, Irie K, Mizuguchi M, Tsunada S, Iwakiri R, Fujimoto K. Clinicaloutcomes ofEMR forgastrictumors: historical pilot evaluationbetweenendoscopicsubmucosaldissectionandconventionalmucosalresection. GastrointestEndosc 2006;63: 776–82.
• 34 Oka S, Tanaka S, Kaneko I,Mouri R, Hirata M, Kawamura T, Yoshihara M, Chayama K. Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. GastrointestEndosc 2006;64:877–83.
• 35 Facciorusso A, Antonino M, Di Maso M, Muscatiello N. Endoscopic submucosal dissection vs endoscopic mucosal resection for early gastric cancer: A meta-analysis. World J GastrointestEndosc2014;6: 555-63.
• 36 Oda I, Saito D, Tada M, Iishi H, Tanabe S, Oyama T, Doi T, Otani Y, Fujisaki J, Ajioka Y, Hamada T, Inoue H, Gotoda T, Yoshida S.A multicenter retrospective study of endoscopic resection for early gastric cancer. Gastric Cancer2006;9:262-70.
• 37 Hoteya S, Iizuka T, Kikuchi D, Yahagi N.Benefits of endoscopic submucosal dissection according to size and location of gastric neoplasm, compared with conventional mucosal resection. J Gastroenterol Hepatol 2009;24:1102-1106.
• 38 Min BH, Lee JH, Kim JJ, Shim SG, Chang DK, Kim YH, Rhee PL, Kim KM, Park CK, Rhee JC. Clinical outcomes of endoscopic submucosal dissection (ESD) for treating early gastric cancer: comparison with endoscopic mucosal resection after circumferential precutting (EMR-P).Dig Liver Dis 2009;41: 201-209
• 39 Tanabe S, Ishido K, Higuchi K, Sasaki T, Katada C, Azuma M, Naruke A, Kim M, Koizumi W. Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a retrospective comparison with conventional endoscopic resection in a single center. Gastric Cancer2014; 17:130-136.
• 40 Choi KS, Jung HY, Choi KD, Lee GH, Song HJ, Kim DH, Lee JH, Kim MY, Kim BS, Oh ST, Yook JH, Jang SJ, Yun SC, Kim SO, Kim JH.EMR versus gastrectomy for intramucosal gastric cancer: comparison of long-term outcomes. Gastrointest Endosc 2011; 73: 942-948
• Etoh T, Katai H, Fukagawa T, Sano T, Oda I, Gotoda T, Yoshimura K, Sasako M. Treatment of early gastric cancer in the elderly patient: results of EMR and gastrectomy at a national referral center in Japan. Gastrointest Endosc 2005; 62: 868-871.
• 42 Nakamoto S, Sakai Y, Kasanuki J, Kondo F, Ooka Y, Kato K, Arai M, Suzuki T, Matsumura T, Bekku D, Ito K, Tanaka T, Yokosuka O. Indicationsfortheuse of endoscopicmucosalresectionforearlygastriccancer in Japan: a comparativestudywithendoscopicsubmucosaldissection. Endoscopy 2009; 41: 746-750.
• 43 Fukunaga S, Machida H, Tominaga K, Tanaka H, Muguruma K, Ohira M, Nagami Y, Sugimori S, Okazaki H, Tanigawa T, Yamagami H, Watanabe K, Watanabe T, Fujiwara Y, Hirakawa K, Arakawa T. Short-and long-term prognosis of patients with early gastric cancer: comparative analysis between endoscopic submucosal dissection and surgical operation Gastrointest Endosc 2012;75:AB234–AB235.
• 44 Chiu PW, Teoh AY, To KF, Wong SK, Liu SY, Lam CC, Yung MY, Chan FK, Lau JY, Ng EK. Endoscopic submucosal dissection (ESD) compared with gastrectomy for treatment of early gastric neoplasia: a retrospective cohort study. SurgEndosc 2012; 26: 3584-3591.
• 45 Zhou P, Peng G, Yang S, Dongfeng C, Yanqing L, Haoxiang Z, Dianchun F, LiqingY. Effectiveness of endoscopic submucosal dissection vs gastrectomy for early gastric cancer and precancerous lesions. J Third Military Med Univ 2014;36:1507–1511.
• 46 Chung MW, Jeong O, Park YK, Lee KH, Lee JH, Lee WS, Joo YE, Choi SK, Cho SB. Comparison on the longterm outcome between endoscopic submucosal dissection and surgical treatment for undifferentiated early gastric cancer. Korean J Gastroenterol2014;63:90–98.
• 47 Kim DY, Hong SJ, Cho GS, Jeong GA, Kim HK, Han JP, Lee YN, Ko BM, Lee MS. Long-term efficacy of endoscopic submucosal dissection compared with surgery for early gastric cancer: a retrospective cohort study. Gut Liver 2014; 8:519–525.
• 48 Sim EH, Kim BW, Kim JH, Kim JJ. Long-term outcome of endoscopic submucosal dissection for early gastric cancer compared to surgical resection. J Clin Oncol 2014;32:Suppl 1.
• 49 Kim BG, Kim BW, Kim JS, Park SM, Lim KJ, Kim JI, Park JM, Oh JH. Comparison of long-term outcome between endoscopic submucosal dissection and surgical resection for early gastric cancer. J Clin Oncol 2015;33:Suppl 1
• 50 Kang HY, Kim SG, Kim JS, Jung HC, Song IS. Clinical outcomes of endoscopic submucosal dissection for undifferentiated early gastric cancer. Surg Endosc 2010; 24: 509-516
• Okada K, Fujisaki J, Yoshida T, Ishikawa H, Suganuma T, Kasuga A, Omae M, Kubota M, Ishiyama A, Hirasawa T, Chino A, Inamori M, Yamamoto Y, Yamamoto N, Tsuchida T, Tamegai Y, Nakajima A, Hoshino E, Igarashi M.Long-term outcomes of endoscopic submucosal dissection for undifferentiated-type early gastric cancer. Endoscopy 2012;44: 122-127.
• 52 Suzuki H, Oda I, Abe S, Sekiguchi M, Nonaka S, Yoshinaga S, Saito Y, Fukagawa T, Katai H. Clinical outcomes of early gastric cancer patients after noncurative endoscopic submucosal dissection in a large consecutive patient series. Gastric Cancer 2016 [Epub ahead of print] [DOI: DOI 10.1007/s10120-016-0651-z]
• 53 Park CH, Lee H, Kim DW, Chung H, Park JC, Shin SK, Hyung WJ, Lee SK, Lee YC, Noh SH. Clinical safety of endoscopic submucosal dissection compared with surgery in elderly patients with early gastric cancer: a propensity-matched analysis. Gastrointest Endosc 2014;80: 599-609.
• 54 Abe N, Gotoda T, Hirasawa T, Hoteya S, Ishido K, Ida Y, Imaeda H, Ishii E, Kokawa A, Kusano C, Maehata T, Ono S, Takeuchi H, Sugiyama M, Takahashi S.Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older. Gastric Cancer2012; 15:70-75.
• 55 Kato M, Nishida T, Hamasaki T, Kawai N, Yoshio T, Egawa S, Yamamoto K, Ogiyama H, Komori M, Nakahara M, Yabuta T, Nishihara A, Hayashi Y, Yamada T, Takehara T.Outcomes of ESD for patients with early gastric cancer and comorbid liver cirrhosis: a propensity scoreanalysis. SurgEndosc 2015; 29: 1560-1566.
• 56 Yoshioka T, Nishida T, Tsujii M, Kato M, Hayashi Y, Komori M, Yoshihara H, Nakamura T, Egawa S, Yoshio T, Yamada T, Yabuta T, Yamamoto K, Kinoshita K, Kawai N, Ogiyama H, Nishihara A, Michida T, Iijima H, Shintani A, Takehara T.Renal dysfunction is an independent risk factor for bleeding after gastric ESD.EndoscInt Open 2015;3: 39-45.
• 57 Najmeh S, Cools-Lartigue J, Mueller C, Ferri LE. Comparing Laparoscopic to Endoscopic Resections for Early Gastric Cancer in a High Volume North American Center. J Gastrointest Surg 2016;20:1547-1553.
• 58 Kim YI, Kim YW, Choi IJ, Kim CG, Lee JY, Cho SJ, Eom BW, Yoon HM, Ryu KW, Kook MC. Long-term survival after endoscopic resection versus surgery in early gastric cancers. Endoscopy 2015;47: 293-301.
• 59 Choi IJ, Lee JH, Kim YI, Kim CG, Cho SJ, Lee JY, Ryu KW, Nam BH, Kook MC, Kim YW.
• Long-term outcome comparison of endoscopic resection and surgery in early gastric cancer meeting the absolute indication for endoscopic resection. Gastrointest Endosc 2015; 81:333-341.
• Yamashina T, Uedo N, Dainaka K, Aoi K, Matsuura N, Ito T, Fujii M, Kanesaka T, Yamamoto S, Akasaka T, Hanaoka N, Takeuchi Y, Higashino K, Ishihara R, Kishi K, Fujiwara Y, Iishi H.Long-term survival after endoscopic resection for early gastric cancer in the remnant stomach: comparison with radical surgery. Ann Gastroenterol2015;28:66-71.
• 61 Wang S, Zhang Z, Liu M, Li S, Jiang C. Endoscopic Resection Compared with Gastrectomy to Treat Early Gastric Cancer: A Systematic Review and Meta-Analysis. PLoS One 2015;10:e0144774.
• 62 Takizawa K, Takashima A, Kimura A, Mizusawa J, Hasuike N, Ono H, Terashima M, Muto M, Boku N, Sasako M, Fukuda H; Gastrointestinal Endoscopy Study Group (GIESG) of Japan Clinical Oncology Group (JCOG); Stomach Cancer Study Group (SCSG) of Japan Clinical Oncology Group (JCOG).A phase II clinical trial of endoscopic submucosal dissection for early gastric cancer of undifferentiated type: Japan Clinical Oncology Group study JCOG1009/1010.Jpn J Clin Oncol 2013;43:87-91.