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Curative resection with endoscopic submucosal dissection of gastric lesions ≥5 cm: To what degree?

Clinical Edge Journal Scan Commentary: Gastric Cancer, September 2022 (1 of 11)

Key clinical point: In patients with early gastric cancer or gastric adenoma, the curative resection rate with endoscopic submucosal dissection (ESD) for lesions sized ≥5 cm is approximately two-thirds of that for lesions <5 cm; however, delayed perforation is more common in the former.

Major finding: In patients with ≥5 and <5 cm lesions, the curative resection rates were 65.6% and 91.5%, respectively, with the rate of delayed perforation being significantly higher in the former (1.6% and 0.1%, respectively; P  =  .019).

Study details: This multicenter retrospective study included 3410 ESD-treated  gastric lesions in patients aged ≥20 years with early gastric cancer or gastric adenoma and categorized them according to lesion size: <5 cm (n = 3282) and ≥5 cm (n = 128).

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Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Chiba H et al. The feasibility and safety of endoscopic submucosal dissection of gastric lesions larger than 5 cm. Gastric Cancer. 2022 (Jul 25). Doi: 10.1007/s10120-022-01323-8