title: Feasibility of Endoscopic Submucosal Dissection for Submucosal-invasive Gastric Cancer and the Predictors of Residual or Recurrent Cancer.
abstract: OBJECTIVE
  The purpose of this study was to determine the feasibility of the endoscopic submucosal dissection (ESD) for submucosal-invasive gastric cancer (SMGC) by assessing the therapeutic outcomes in patients treated with ESD.
  
  
  METHODS
  From 2002 to 2013, ESD was performed for 597 lesions with early gastric cancer at our institute. ESD of the SMGC was performed for 85 patients.
  
  
  RESULTS
  Among these 85 patients, 35 patients underwent additional gastrectomy. Residual or recurrent cancer occurred in 12 patients treated through ESD method. The 5-year disease-specific survival rates were 94.9% for all 85 patients and 97.2% for 49 patients with follow-up examinations after ESD. The multivariate logistic regression analysis indicated that residual or recurrent cancer in the patients with SMGC was significantly associated with a tumor width in submucosa (P=0.0152).
  
  
  CONCLUSIONS
  ESD for SMGC can be considered feasible in clinical practice in terms of the favorable long-term oncologic outcomes.
authors.affiliation: Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Ojima
authors.forename: Katsunari
authors.initials: K
authors.lastname: Takifuji
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakamura
authors.forename: Mikihito
authors.initials: M
authors.lastname: Nakamori
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D000069916:Endoscopic Mucosal Resection / Q000379:methods* / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods / Q000401:mortality; D005773:Gastroscopy / Q000379:methods / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000401:mortality; D018365:Neoplasm, Residual / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome