Clinical Outcomes of the Endoscopic Submucosal Dissection of Early Gastric Cancer Are Comparable between Absolute and New Expanded Criteria

BACKGROUND/AIMS Advances in endoscopic submucosal dissection (ESD) techniques have led to the development of expanded criteria for endoscopic resection of early gas-tric cancer (EGC). The aim of this study was to evaluate the short- and long-term outcomes for ESD using indication cri-teria. METHODS A total of 1,105 patients underwent ESD for EGC at six medical centers. The patients were classified into the following two groups based on the lesion size, presence of ulceration and pathological review an absolute criteria group (n=517) and an expanded criteria group (n=588). RESULTS The curative resection rates (91.1% vs 91.3%, p=0.896) were similar in the absolute criteria group and the expanded criteria group. The en bloc resection rates (93.4% and 92.3%, respectively; p=0.488) and complete resection rates (98.3% and 97.4%, respectively; p=0.357) did not differ between the groups. The cumulative disease-free survival rates and the overall survival rates were similar between the groups (p=0.778 and p=0.654, respectively). Independent factors for the curative resection of EGC included tumor lo-cation (upper vs middle and lower, 2.632 [1.128-6.144] vs 3.497 [1.560-7.842], respectively) and en bloc resection rate 12.576 [7.442-21.250]. CONCLUSIONS The expanded criteria for ESD in cases of EGC is comparable with the widely ac-cepted pre-existing criteria. (Gut Liver, 2015;9181-187).