Prospective comparative study of endoscopic submucosal dissection and gastrectomy for early neoplastic lesions including patients' perspectives.


Journal

Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166

Informations de publication

Date de publication:
01 2019
Historique:
pubmed: 4 7 2018
medline: 30 8 2019
entrez: 4 7 2018
Statut: ppublish

Résumé

There are no prospective studies comparing endoscopic submucosal dissection (ESD) and gastrectomy, especially evaluating patient-reported outcomes. Our aim was to compare the safety and impact on quality of life (QoL) of ESD and gastrectomy in patients with early gastric neoplasia. This prospective study included consecutive patients presenting with early gastric neoplasia in a tertiary center from January 2015 to August 2016. Data collection included curative resection, adverse events (AEs), and patient-reported outcomes (questionnaires: EORTC QLQ-C30, EORTC STO-22, EQ-5D-5 L, and Assessment of Survivor Concerns) before and after interventions (after 1 month, 3 - 6 months, and 1 year). 254 patients with early lesions were included: 153 managed by ESD and 101 by gastrectomy, the former being significantly older and with less advanced lesions. Mean procedural time and length of stay were significantly higher in the surgery group (164 vs In patients with early gastric neoplasia, ESD is safer and is associated with a positive impact on health-related QoL when compared with gastrectomy, without increasing fear of recurrence and new lesions.

Sections du résumé

BACKGROUND
There are no prospective studies comparing endoscopic submucosal dissection (ESD) and gastrectomy, especially evaluating patient-reported outcomes. Our aim was to compare the safety and impact on quality of life (QoL) of ESD and gastrectomy in patients with early gastric neoplasia.
METHODS
This prospective study included consecutive patients presenting with early gastric neoplasia in a tertiary center from January 2015 to August 2016. Data collection included curative resection, adverse events (AEs), and patient-reported outcomes (questionnaires: EORTC QLQ-C30, EORTC STO-22, EQ-5D-5 L, and Assessment of Survivor Concerns) before and after interventions (after 1 month, 3 - 6 months, and 1 year).
RESULTS
254 patients with early lesions were included: 153 managed by ESD and 101 by gastrectomy, the former being significantly older and with less advanced lesions. Mean procedural time and length of stay were significantly higher in the surgery group (164 vs
CONCLUSIONS
In patients with early gastric neoplasia, ESD is safer and is associated with a positive impact on health-related QoL when compared with gastrectomy, without increasing fear of recurrence and new lesions.

Identifiants

pubmed: 29969807
doi: 10.1055/a-0628-6601
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

30-39

Commentaires et corrections

Type : CommentIn

Informations de copyright

© Georg Thieme Verlag KG Stuttgart · New York.

Déclaration de conflit d'intérêts

None

Auteurs

Diogo Libânio (D)

Gastroenterology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.
CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.

Vânia Braga (V)

Gastroenterology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.

Sílvia Ferraz (S)

Gastroenterology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.

Rui Castro (R)

Gastroenterology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.

Jorge Lage (J)

Gastroenterology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.

Inês Pita (I)

Gastroenterology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.

Cátia Ribeiro (C)

Surgical Oncology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.

Joaquim Abreu De Sousa (J)

Surgical Oncology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.

Mário Dinis-Ribeiro (M)

Gastroenterology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.
CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.

Pedro Pimentel-Nunes (P)

Gastroenterology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.
CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.

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