Effectiveness of Endoscopy for Gastric Cancer Screening in Fukushima City

Tu1706 Long-Term Results Over 10 Years of Endoscopic Submucosal Dissection for Early Gastric Cancer Weon-Jin Ko*, Joo Young Cho, Ki Baik Hahm, Pil Won Park, Sung-Pyo Hong, Kwang Hyun Ko, Kim Wonhee, Jun Hwan Yoo, Duk Hwan Kim, Jun-Hyung Cho Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea (the Republic of); Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea (the Republic of) Background/Aims: Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is considered as standard therapy in Korea. However, the long term clinical outcomes over 10 years remain unknown. We investigated the tumor recurrence and survival after ESD for EGC during 10 years. Methods: ESD was performed for patients with EGC thatfulfilled the expanded criteria: mucosal cancer withoutulcer findings irrespective of tumour size; mucosal cancerwith ulcer findings %3 cm in diameter; submucosal invasive cancer %3 cm in size; and minute undifferentiated mucosal cancer without ulcer findings %2 cm in diameter.We reviewed medical records of 84patients who underwent ESD for EGC from October, 2003 to August, 2004. The patientsunderwent ESD and then received periodic endoscopicfollow-up and metastatic surveys over 10 years. The main outcome measures werecurability (curative or non-curative), recurrent rate, and survival rates. Results: 74 of 84 lesions (88.1%) were deemed tohave undergone curative resection. 8 patients underwent additional surgery for incomplete resection or complicationfollowing ESD. Only 1 patient was diagnosed local recurrence after ESD and she underwent additional surgery. The 10 year overall survival rates and disease free survival of the patients after ESD were followed up for over 10 years was 89.2% (66/74) and 98.5% (65/66), respectively. A total of patients 8 expired, but causes of death are not related gastric cancer. Conclusions: The 10 year overall survival and disease free survival of ESD for EGC are excellent. Expanded indications for ESD can be applied safely to EGC.