Effect of additional surgery after noncurative endoscopic submucosal dissection for early XXXX .

@entity1 @entity101 @entity356 @entity3
BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) is a standard treatment for early @entity356 (EGC) without lymph node @entity3 . However, some @entity1 undergo noncurative ESD. The aim of the present study was to assess the long-term clinical outcomes of noncurative ESD with or without additional surgery. @entity1 AND METHODS: We investigated the chart data from all @entity1 who had undergone ESD for EGC at Saga Medical School Hospital and Saga Prefectural Medical Centre Koseikan between 2001 and 2012. A total of 957 cases (1047 lesions) of EGC underwent ESD, and 99 had noncurative ESD. In total, 20 cases were excluded because their follow-up period was <3 years. We divided the @entity1 into observation and additional surgery groups, and we compared the survival rate and related factors between the groups. RESULTS: After noncurative ESD, 28/79 @entity1 (35.4%) underwent additional surgery and 51/79 (64.6%) were followed up without surgery. The average age of @entity1 in the observation group was higher than that of the additional surgery group (75.9 vs. 71.6 years; P=0.03). The incidence of @entity101 was significantly higher in the observation group compared with the additional surgery group (51.0 vs. 25.9%; P=0.03). The overall survival rate of the additional surgery group was longer than that of the observation group.However, only one @entity1 died from @entity356 in the observation group.The disease-specific survival rate did not differ significantly between the groups. CONCLUSIONS: It might be acceptable to follow up without additional surgery for some @entity1 with comorbidity and who were elderly after noncurative ESD for EGC.
