Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 102 (11), 1394-401

Effect of Rescue Surgery After Non-Curative Endoscopic Resection of Early Gastric Cancer

Affiliations

Effect of Rescue Surgery After Non-Curative Endoscopic Resection of Early Gastric Cancer

E R Kim et al. Br J Surg.

Abstract

Background: Whether rescue surgery confers a survival benefit in patients undergoing non-curative endoscopic resection of early gastric cancer remains controversial.

Methods: This was a retrospective review of patients who underwent non-curative endoscopic resection of at least one lesion of differentiated-type early gastric cancer between 2000 and 2011. Patients with a positive lateral resection margin as the only non-curative factor were excluded. Outcome was investigated by univariable (Kaplan-Meier) and multivariable (Cox proportional hazards) analysis.

Results: Some 341 patients underwent non-curative endoscopic resection for at least one lesion of differentiated-type early gastric cancer. Sixty-seven patients with a positive lateral resection margin as the only non-curative factor were excluded, leaving 274 patients for analysis; 194 had rescue surgery and 80 had no additional treatment. The median duration of follow-up was 60·5 months. Patients who had rescue surgery were younger, had a lower Charlson co-morbidity index score, smaller tumours and a higher lymphovascular invasion rate than patients with no treatment. Among 194 patients who had rescue surgery, intragastric local residual tumours were found in ten (5·2 per cent) and lymph node metastases in 11 (5·7 per cent). Patients with lymph node metastasis were significantly older than those without metastasis; no other significant differences were found. Univariable analysis showed that patients aged less than 65 years, those with a Charlson co-morbidity index score below 4 and patients undergoing rescue surgery had significantly longer overall survival. Five-year overall survival rates in the rescue surgery and no-treatment groups were 94·3 and 85 per cent respectively. In multivariable analysis, rescue surgery was identified as the only independent predictor of overall survival after non-curative endoscopic resection of early gastric cancer.

Conclusion: Rescue surgery confers a survival benefit after non-curative endoscopic resection of early gastric cancer.

Similar articles

See all similar articles

Cited by 20 PubMed Central articles

See all "Cited by" articles

Publication types

LinkOut - more resources

Feedback