Long‑term outcome of the endoscopic submucosal dissection of early gastric cancer: A comparison between patients with and without liver cirrhosis

Kim,Seung Han; Joo,Moon Kyung; Yoo,Ah-Young; Kim,Seong Min; Kim,Won Shik; Lee,Beom Jae; Park,Jong Jae; Chun,Hoon Jai; Lee,Sang Woo

doi:10.3892/ol.2022.13524

Long‑term outcome of the endoscopic submucosal dissection of early gastric cancer: A comparison between patients with and without liver cirrhosis

Authors:
- Seung Han Kim
- Moon Kyung Joo
- Ah-Young Yoo
- Seong Min Kim
- Won Shik Kim
- Beom Jae Lee
- Jong Jae Park
- Hoon Jai Chun
- Sang Woo Lee
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Affiliations: Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Gastrointestinal Medical Instrument Research, Korea University College of Medicine, Seoul 02841, Republic of Korea, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi 15355, Republic of Korea
Published online on: September 22, 2022 https://doi.org/10.3892/ol.2022.13524
Article Number: 404

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Abstract

Gastric cancer (GC) and liver cirrhosis (LC) have high incidence rates, particularly in Eastern Asia; however, the long‑term clinical outcomes or recurrence of GC following endoscopic submucosal dissection (ESD) in patients with comorbid LC remain unclear. The present study aimed to compare the long‑term efficacy and safety of ESD in patients with GC, with and without LC. Patients with early GC (EGC) who had underlying LC and underwent endoscopic treatment (LC‑EGC group) were enrolled in the present study. In addition, patients with EGC without LC (non‑LC‑EGC group) were matched at a ratio of 1:3 via propensity score matching. The clinical outcomes and histopathological data of both groups were analyzed. No significant differences were observed in procedure type, complications [intraprocedural bleeding (11.8%) and perforation (0.0%)], en bloc resection rate (94.1%) and complete resection rate (100%) between the two groups. Multivariate Cox regression analysis demonstrated that procedure time was significantly associated with procedure‑associated bleeding [adjusted hazard ratio (HR), 1.017; 95% confidence interval (CI), 1.001‑1.032; P=0.033]. Furthermore, LC was significantly associated with cancer recurrence (adjusted HR, 5.482; 95% CI, 1.102‑27.279; P=0.038). Taken together, the results of the present study suggest that endoscopic resection of EGC in patients with LC is an effective and safe treatment method. However, further studies are required to assess recurrence.

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