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