title: Long-term survival after endoscopic resection for early gastric cancer in the remnant stomach: comparison with radical surgery.
abstract: BACKGROUND
  Endoscopic resection (ER) has recently become standard treatment, even for early gastric cancer (EGC) in the remnant stomach. We aimed to compare long-term survival after ER versus radical surgery for EGC in the remnant stomach.
  
  
  METHODS
  We retrospectively compared overall and cause-specific survival of patients who had undergone ER or radical surgery for EGC in the remnant stomach from 1998 to 2012.
  
  
  RESULTS
  During the study period, 32 patients with intramucosal (M), two with shallow submucosal (SM1) and eight with deep submucosal (SM2) cancers had undergone ER (ER group) whereas six with M and seven with SM2 cancers had undergone surgery (surgery group). All patients were followed up for a median of 60 months; during follow up, 15 patients died, including three in the ER group with SM2 cancer who died of gastric cancer. The overall 5-year survival rates of M-SM1 and SM2 cancer patients in the ER and surgery groups were 89%, 48%, 80%, and 67%, respectively (P=0.079). The disease-specific 5-year survival rates of M-SM1 and SM2 cancer patients in the ER and surgery groups were 100%, 48%, 100%, and 100%, respectively (P=0.000). Operation time and hospital stay were significantly shorter in the ER than the surgery group (P<0.001). Grade 2 perforation occurred in two patients in the ER group and Grade 3 anastomotic leakage in two patients in the surgery group.
  
  
  CONCLUSIONS
  ER provides excellent outcomes, comparable with those of radical surgery, in patients with M-SM1 gastric cancer in the remnant stomach; however, patients with SM2 cancer require radical surgery.
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashina
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Noriya
authors.initials: N
authors.lastname: Uedo
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Dainaka
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Aoi
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Matsuura
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Fujii
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanesaka
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Akasaka
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Hanaoka
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Takeuchi
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Higashino
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Ryu
authors.initials: R
authors.lastname: Ishihara
authors.affiliation: Department of Gastrointestinal Surgery (Kentaro Kishi, Yoshiyuki Fujiwara), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kishi
authors.affiliation: Department of Gastrointestinal Surgery (Kentaro Kishi, Yoshiyuki Fujiwara), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Fujiwara
authors.affiliation: Department of Gastrointestinal Oncology (Takeshi Yamashina, Noriya Uedo, Katsuyuki Dainaka, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi), Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iishi
keywords: Keywords Early gastric cancer in the remnant stomach; endoscopic muosal resection; endoscopic submucosal dissection; long-term outcomes