title: Outcomes of endoscopic submucosal dissection for early gastric cancer and factors associated with incomplete resection.
abstract: OBJECTIVE
  The introduction of endoscopic submucosal dissection for the treatment of early gastric cancer has enabled en bloc resection of lesions that cannot be treated with conventional endoscopic mucosal resection. Despite expansion of indications for endoscopic treatment, a considerable number of patients still require additional treatment. The objective of this study was to summarize the outcomes of endoscopic submucosal dissection performed on patients with early gastric cancer and to identify factors associated with incomplete resection and non-curative resection.
  
  
  METHODS
  This study examined 605 lesions in 533 patients with early gastric cancer who underwent endoscopic submucosal dissection. Evaluation of treatment outcome was based on the rates of complete resection and curative resection. Factors associated with incomplete resection and non-curative resection were retrospectively identified.
  
  
  RESULTS
  Of the 605 lesions, 562 (92.9%) and 510 (84.3%) were diagnosed as complete resection and curative resection, respectively. Factors identified as associated with incomplete resection were tumor size ≥30 mm, location in the U region, undifferentiated carcinoma, sm2 invasion and ulceration. Factors identified as associated with non-curative resection were tumor size ≥30 mm, location in the U region and ulceration.
  
  
  CONCLUSIONS
  Incomplete and non-curative resection appears to be associated with preoperative diagnosis of lesions and technical difficulty.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Goto
authors.forename: Jun
authors.initials: J
authors.lastname: Nishikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamoto
authors.forename: Kouichi
authors.initials: K
authors.lastname: Hamabe
authors.forename: Junnichi
authors.initials: J
authors.lastname: Nishimura
authors.forename: Munetaka
authors.initials: M
authors.lastname: Nakamura
authors.forename: Shu
authors.initials: S
authors.lastname: Kiyotoki
authors.forename: Mari
authors.initials: M
authors.lastname: Saito
authors.forename: Osamu
authors.initials: O
authors.lastname: Miura
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome