SHORT AND MID TERM RESULTS OF ENDOSCOPIC SUBMUCOSAL DISSECTION IN EARLY GASTRIC CANCER: PROSPECTIVE STUDY IN PERU 2012 – 2018

Aims:

Endoscopic submucosal dissection (ESD) is a treatment modality for superficial gastric neoplasms that has proven to be useful in multiple oriental studies; however, given its technical difficulty, it is not commonly used in the West. In the present study we evaluate the short and mid term results of ESD in the treatment of early gastric cancer (EGC) in two reference centers in Peru.

Methods:

We prospectively included all patients undergoing ESD for EGC from July 2012 to July 2018 in two medical centers. The rate of en bloc, complete and curative resections were calculated, as well as the complication rate. The rate of recurrences and the appearance of metachronous lesions were determined. In addition, a global and disease-free survival analysis were performed after resection.

Results:

In the period described, a total of 94 patients with 105 EGC were included. The medians of the measurement of the lesions and the time of the procedure were 20 mm and 50 min, respectively. The rates of en bloc, complete and curative resection were 99%, 98% and 92%, respectively. There were 7 cases of perforation (6.7%) and 4 cases of late bleeding (3.8%). A patient with perforation had to undergo surgery. Within the group of curative resections there was a case of local recurrence (1.4%) and four cases of metachronous EGC (6%).

Tab. 1:

Histopathological analysis

Curative resection
Guideline criteria	49 (46.67)
Expanded criteria – Differentiated	47 (44.76)
Expanded criteria – Undifferentiated	1 (0.95)
Non-curative resection	8 (7.62)

Conclusions:

Gastric ESD is a feasible treatment modality to be performed in our country, being effective and safe when performed by trained endoscopists and in reference centers.