Long-term outcomes after endoscopic submucosal dissection versus surgery for adenocarcinoma of the esophagogastric junctionOutstanding Poster Award

Background: Endoscopic submucosal dissection (ESD) for early gastric cancer has been accepted as standard treatment. However, comparative outcomes of ESD and surgery have not been evaluated for adenocarcinoma in the esophagogastric junction (EGJ). Methods: Subjects who underwent ESD or surgery for Siewert type II adenocarcinoma between 2005 and 2010 were eligible for this study. Clinical features and treatment outcomes were retrospectively reviewed using medical records.Results: Among 79 patients, 40 underwent ESD and 39 underwent surgery. During the median follow-up period of 60.9 months (range: 13.1-125.4 months), the 5-year overall survival rates were 93.9% and 97.3% for ESD and surgery groups, respectively (p=0.376). There was no gastric cancer-related deaths in either groups. The 5-year recurrence rate was higher for ESD group than surgery group (13.8% vs. 0%, p=0.013), because synchronous or metachronous lesions were developed only in the ESD group. Conclusions: ESD may be an effective alternative to surgery for the treatment of early gastric cancer in the EGJ, based on a comparable long-term outcomes.