Endoscopic submucosal dissection for gastric superficial neoplastic lesions: a single center experience

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Aims To evaluate outcome of endoscopic submucosal dissection (ESD) for Tis/T1 gastric superficial neoplastic lesions Methods We retrospectively collected data of consecutive patients undergoing ESD for Tis/T1 gastric superficial neoplastic lesions from May 2018 to June 2022 Results 63 lesions in 53 patients (32 M, median age 72 yrs) were included. Median lesions diameter was 20 mm (IQ). 40% were located in the antrum, 16% in the angulus, 25% in the corpus, 14% in the cardia, 2% in the fundus and 3% on the gastrojejunal anastomosis. The most frequent morphologies of the lesions were IIa-c (51%) and IIa (27%) according to Paris classification. 24% of the lesions were ulcerated. ESD specimen showed high grade dysplasia in 13/63 (21%) lesions and adenocarcinoma in 50/63 (79%) lesions. In 12/63 (19%) ESD was not curative due to submucosal invasion > 500 micron (11/12) and to angioinvasive signet ring cells carcinoma (1/12). Surgical specimen showed no residual disease or lymph nodes involvement in 5/12 (42%) patients, whereas in 7/12 (58%) patients residual tumor or lymph nodes involvement was demonstrated. Mean follow-up time was 22 months. Only in one patient was observed recurrence, treated with ESD and subsequent surgery for invasive carcinoma. Conclusions We showed that ESD is a curative treatment in almost 80% of Tis/T1 gastric superficial neoplastic lesions. Among patients referred to surgery, almost 60% had no residual tumor or lymph nodes involvement in the surgical specimen. Publication History Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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