Outcomes of endoscopic submucosal dissection for early gastric cancer and precancer lesion: Experience from a center in Southern Taiwan

Limited data are available on the interval of disease-free status after endoscopic submucosal dissection (ESD) for early gastric cancer and precancer lesion in Taiwan. In this long-term (2–105 months) follow-up study, we analyzed the risk factors that affect the local recurrence and noncurative resection (non-CR) of these lesions. We retrospectively studied 65 consecutive treatment-naïve patients with 69 EGC lesions who were selected to be treated by ESD. A total of 56 lesions (48 CR lesions and 8 non-CR lesions) were analyzed for local recurrence after ESD. ESD was curative for gastric epithelial tumors in 51 (73.9%) but not in 18 (26.1%) lesions. Unfortunately, five (8.93%) of these 56 lesions in 53 patients had local recurrence. None of the patients died from gastric cancer-associated diseases during follow-up. In our studies, the cumulative local recurrence rates were 5.3% in the CR group and 56.7% in the non-CR group (p = 0.0091). The disease-free status was high (94.7%) with CR. The risk factors that affect the non-CR were tumor location (p = 0.013), deeper invasion (p < 0.001), undifferentiated histopathology (p < 0.001), and ulcer presence (p = 0.045). ESD offers good outcome after treatment for EGC. To decrease the risk of local recurrence, preoperative diagnosis of tumor extent and accurate postoperative pathological evaluation are very important