title: [Comparison on the long term outcome between endoscopic submucosal dissection and surgical treatment for undifferentiated early gastric cancer].
abstract: OBJECTIVE
  There are controversies on the efficacy and safety of endoscopic submucosal dissection (ESD) for un-differentiated early gastric cancer (EGC) despite the expansion of ESD indications. The aim of this study was to evaluate the long term outcome of ESD compared to that of surgical treatment in patients with undifferentiated EGC.
  
  
  METHODS
  A total of 76 patients who underwent ESD for undifferentiated EGC and 149 patients who met the ESD indication and received surgical treatment from January 2005 to December 2010 at Chonnam National University Hwasun Hospital were included.
  
  
  RESULTS
  In the ESD group, en bloc resection and complete resection were achieved in 84.2% (64/76) and 76.3% (58/76) of patients, respectively. Among these patients, 58 (76.3%) met the ESD indication (indication group), and the remaining 18 (23.7%) did not meet the ESD indication (above indication group). Complete resection rates for indication group and above indication group were 86.2% (50/58) and 44.4% (8/18), respectively (p<0.05). The mean follow-up period was 42.2 ± 19.2 months. Total recurrence rates in the ESD group and operation group were 14.1% (9/76) and 0.7% (1/149), respectively (p<0.05). The main complication of ESD was bleeding (5.2%, 4/76). In the operation group, 2 (1.3%) patients died from postoperative bleeding and leakage of anastomosis site.
  
  
  CONCLUSIONS
  ESD may be a feasible and safe treatment modality compared to that of surgical treatment for undifferentiated EGC when managed according to the expanded criteria. However, close endoscopic surveillance is required in this group because of higher incidence of intragastric recurrence.
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 501-757, Korea.
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Chung
authors.forename: Oh
authors.initials: O
authors.lastname: Jeong
authors.forename: Young Kyu
authors.initials: YK
authors.lastname: Park
authors.forename: Kyung Hwa
authors.initials: KH
authors.lastname: Lee
authors.forename: Jae Hyuk
authors.initials: JH
authors.lastname: Lee
authors.forename: Wan Sik
authors.initials: WS
authors.lastname: Lee
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Joo
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Choi
authors.forename: Sung Bum
authors.initials: SB
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D005773:Gastroscopy; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome