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A small but substantial number of patients with early gastric cancer who undergo endoscopic submucosal dissection (ESD) are found to have tumors that, upon pathological examination, did not meet the criteria for ESD and are upgraded to a higher stage. Because of the higher risk for metastases, surgery is recommended in these cases.
To determine if long-term outcomes are inferior when surgery is not performed in this setting, investigators at the National Cancer Center in Korea reviewed the records of 2018 patients with early gastric cancer who had tumors that did not meet the criteria for ESD but who received either ESD or surgery as initial treatment during a 10-year period. Of these patients, 127 underwent surgery after ESD and 67 who did …