Efficacy and safety of endoscopic submucosal dissection for early gastric cancer in patients with comorbid diseases.
OBJECTIVE
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.
Kim
Beom Jin
BJ
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Chang
Tae Hoon
TH
Kim
Jae J
JJ
Min
Byung-Hoon
BH
Lee
Jun Haeng
JH
Son
Hee Jung
HJ
Rhee
Poong-Lyul
PL
Rhee
Jong Chul
JC
Kim
Kyung Mee
KM
Park
Chul Keun
CK