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Efficacy and Safety of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients with Comorbid Diseases
Authors:Beom Jin Kim   Tae Hoon Chang   Jae J. Kim   Byung-Hoon Min   Jun Haeng Lee   Hee Jung Son   Poong-Lyul Rhee   Jong Chul Rhee   Kyung Mee Kim     Chul Keun Park
Affiliation:*Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.;Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.;Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract:

Background/Aims

Endoscopic submucosal dissection (ESD), a new and potentially curative method for treating gastrointestinal neoplasms, may have longer procedure time and the risk of complications when compared to conventional endoscopic mucosal resection. This study evaluated the efficacy and safety of ESD in patients with comorbid diseases.

Methods

The outcomes of 337 patients who underwent ESD for early gastric cancer at Samsung Medical Center from April 2003 to December 2006 were analyzed retrospectively. The Charlson comorbidity scale was used to divide the patients into low-risk (no risk factor) and high-risk (at least one risk factor) groups. The outcomes and complications were compared between the high- and low-risk groups.

Results

The low- and high-risk groups comprised 240 and 97 patients with mean ages of 61.1 and 64.7 years, respectively (p=0.002). Tumor location, tumor size, depth of invasion, procedure duration, and rates of en bloc resection, complete resection, complication, and recurrence did not differ significantly between the two groups (p>0.05).

Conclusions

ESD may be a safe and effective treatment for early gastric cancer in patients with comorbid diseases.
Keywords:Early gastric cancer   Endoscopic submucosal dissection   Comorbid disease   Complication
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