日本語フィールド
著者：*Suzuki H, Ono H, Hirasawa T, Takeuchi Y, Ishido K, Hoteya S, Yano T, Tanaka S, Toya Y, Nakagawa M, Toyonaga T, Takemura K, Hirasawa K, Matsuda M, Yamamoto H, Tsuji Y, Hashimoto S, Yuki M, Oyama T, Takenaka R, Yamamoto Y, Naito Y, Yamamoto K, Kobayashi N, Kawahara Y, Hirano M, Koizumi S, Hori S, Tajika M, Hikichi T, Yao K, Yokoi C, Ohnita K, Hisanaga Y, Sumiyoshi T, Kitamura S, Tanaka H, Shimoda R, Shimazu T, Takizawa K, Tanabe S, Kondo H, Iishi H, Ninomiya M, Oda I; J-WEB/EGC group題名：Long-term Survival After Endoscopic Resection For Gastric Cancer: Real-world Evidence From a Multicenter Prospective Cohort 発表情報：Clin Gastroenterol Hepatol 巻: 21 号: 2 ページ: 307-318.e2キーワード：Early Gastric Cancer; Endoscopic Resection; Endoscopic Submucosal Dissection; Long-term Survival; Multicenter Prospective Cohort Study概要：Background & aims: We aimed to clarify the long-term outcomes of endoscopic resection (ER) for early gastric cancers (EGCs) based on pathological curability in a multicenter prospective cohort study.
Methods: We analyzed the long-term outcomes of 9054 patients with 10,021 EGCs undergoing ER between July 2010 and June 2012. Primary endpoint was the 5-year overall survival (OS). The hazard ratio for all-cause mortality was calculated using the Cox proportional hazards model. We also compared the 5-year OS with the expected one calculated for the surgically resected patients with EGC. If the lower limit of the 95% confidence interval (CI) of the 5-year OS exceeded the expected 5-year OS minus a margin of 5% (threshold 5-year OS), ER was considered to be effective. Pathological curability was categorized into en bloc resection, negative margins, and negative lymphovascular invasion: differentiated-type, pT1a, ulcer negative, ?2 cm (Category A1); differentiated-type, pT1a, ulcer negative, >2 cm or ulcer positive, ?3 cm (Category A2); undifferentiated-type, pT1a, ulcer negative, ?2 cm (Category A3); differentiated-type, pT1b (SM1), ?3 cm (Category B); or noncurative resections (Category C).
Results: Overall, the 5-year OS was 89.0% (95% CI, 88.3%-89.6%). In a multivariate analysis, no significant differences were observed when the hazard ratio of Categories A2, A3, and B were compared with that of A1. In all the pathological curability categories, the lower limit of the 95% CI for the 5-year OS exceeded the threshold 5-year OS.
Conclusion: ER can be recommended as a standard treatment for patients with EGCs fulfilling Category A2, A3, and B, as well as A1 (UMIN Clinical Trial Registry, UMIN000005871).抄録：英語フィールド
Author：*Suzuki H, Ono H, Hirasawa T, Takeuchi Y, Ishido K, Hoteya S, Yano T, Tanaka S, Toya Y, Nakagawa M, Toyonaga T, Takemura K, Hirasawa K, Matsuda M, Yamamoto H, Tsuji Y, Hashimoto S, Yuki M, Oyama T, Takenaka R, Yamamoto Y, Naito Y, Yamamoto K, Kobayashi N, Kawahara Y, Hirano M, Koizumi S, Hori S, Tajika M, Hikichi T, Yao K, Yokoi C, Ohnita K, Hisanaga Y, Sumiyoshi T, Kitamura S, Tanaka H, Shimoda R, Shimazu T, Takizawa K, Tanabe S, Kondo H, Iishi H, Ninomiya M, Oda I; J-WEB/EGC groupTitle：Long-term Survival After Endoscopic Resection For Gastric Cancer: Real-world Evidence From a Multicenter Prospective Cohort Announcement information:Clin Gastroenterol Hepatol Vol: 21 Issue: 2 Page: 307-318.e2Keyword：Early Gastric Cancer; Endoscopic Resection; Endoscopic Submucosal Dissection; Long-term Survival; Multicenter Prospective Cohort StudyAn abstract：Background & aims: We aimed to clarify the long-term outcomes of endoscopic resection (ER) for early gastric cancers (EGCs) based on pathological curability in a multicenter prospective cohort study.
Methods: We analyzed the long-term outcomes of 9054 patients with 10,021 EGCs undergoing ER between July 2010 and June 2012. Primary endpoint was the 5-year overall survival (OS). The hazard ratio for all-cause mortality was calculated using the Cox proportional hazards model. We also compared the 5-year OS with the expected one calculated for the surgically resected patients with EGC. If the lower limit of the 95% confidence interval (CI) of the 5-year OS exceeded the expected 5-year OS minus a margin of 5% (threshold 5-year OS), ER was considered to be effective. Pathological curability was categorized into en bloc resection, negative margins, and negative lymphovascular invasion: differentiated-type, pT1a, ulcer negative, ?2 cm (Category A1); differentiated-type, pT1a, ulcer negative, >2 cm or ulcer positive, ?3 cm (Category A2); undifferentiated-type, pT1a, ulcer negative, ?2 cm (Category A3); differentiated-type, pT1b (SM1), ?3 cm (Category B); or noncurative resections (Category C).
Results: Overall, the 5-year OS was 89.0% (95% CI, 88.3%-89.6%). In a multivariate analysis, no significant differences were observed when the hazard ratio of Categories A2, A3, and B were compared with that of A1. In all the pathological curability categories, the lower limit of the 95% CI for the 5-year OS exceeded the threshold 5-year OS.
Conclusion: ER can be recommended as a standard treatment for patients with EGCs fulfilling Category A2, A3, and B, as well as A1 (UMIN Clinical Trial Registry, UMIN000005871).