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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(07): E989-E993
DOI: 10.1055/a-1478-3281
Original article

Management of early gastric cancer meeting criteria for endoscopic resection: US population-based study

Mohamed Barakat
1   Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Brooklyn, New York, United States
,
Daryl Ramai
2   Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York, United States
,
Derrick Cheung
1   Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Brooklyn, New York, United States
,
Mohamed M. Abdelfatah
3   Division of Gastroenterology and Hepatology, University of Alabama, Birmingham, Alabama, United States
,
Mohamed O. Othman
4   Division of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, United States
,
David L. Carr-Locke
5   Division of Gastroenterology and Hepatology, New York Presbyterian, New York, New York, United States
,
Douglas G. Adler
6   Division of Gastroenterology and Hepatology, Utah University, Salt Lake City, Utah, United States
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Referred to by:

Overutilization of surgery for superficial gastric carcinoma in USA: is it still the case in 2020?Endosc Int Open 2021; 09(07): E994-E996
DOI: 10.1055/a-1393-5804

Abstract

Background and study aims The goal of this study was to assess surgical resection (SR) of early gastric cancer (EGC) fitting Japanese Gastric Cancer Association (JGCA) endoscopic resection (ER) criteria.

Patients and methods We analyzed EGC data from the national Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015.

Results A total of 2219 EGC cases were identified (1074 T1a and 1145 T1b). Of them, 409 met absolute criteria, 219 met expanded 1, 529 expanded 2, and 229 expanded 3. 259 lesions were treated endoscopically while 1007 were surgically resected (20.5 % vs 79.5 %, P = 0.0001). Temporal analysis showed that the frequency of ER steadily increased while SR proportionally decreased during the study period. Cox proportion regression analysis adjusting for confound variables (including age, gender, and race) showed no significant difference in the risk of mortality following either surgery or endoscopy.

Conclusions EGC can be safely treated with ER. However, EGC meeting JGCA ER criteria is largely treated with SR in the United States.



Publication History

Received: 02 December 2020

Accepted: 08 March 2021

Article published online:
17 June 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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