Abstract
Background/Aim: Endoscopic submucosal dissection(ESD) is a new method for the curative treatment of gastrointestinal neoplasm. Increased operation time and complication risks with ESD compared with EMR remain problematic. The aim of the present study is to evaluate the efficacy and safety of ESD in patients with comorbid diseases. Methods: From April 2003 through December 2006, 306 patients treated by ESD for early gastric cancer at Samsung Medical Center were retrospectively analyzed. They were categorized as low risk group (score 0) and high risk group (score 1-4) according to Charlson comorbidity scale which has been used to estimate the risk of death from comorbid diseases in oncologic condition. Location, size, depth of invasion, procedure time, complete en bloc resection rate, complication, recurrence of high risk group were compared with those of low risk group. Results: Seventy seven patients had high risk diseases listed in Charlson's comorbidity scale and 229 patients had none or low risk diseases. The mean age of high risk group was 65.8 yr whereas that of low risk group was 60.9 yr (p < 0.001). There were no significant differences in the location, size, depth of invasion, procedure time between the two groups (p > 0.05). There were no significant difference in the complete en bloc resection rate, complication and recurrence rate between the two groups (p > 0.05). Conclusion: ESD could be a safe and effective treatment for early gastric cancer in patients with comorbid diseases.
Published Version
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