{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:36:12Z","timestamp":1762176972577,"version":"3.40.4"},"reference-count":0,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2016,11,30]],"date-time":"2016-11-30T00:00:00Z","timestamp":1480464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2016,11,30]],"date-time":"2016-11-30T00:00:00Z","timestamp":1480464000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["GE Port J Gastroenterol"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;\/i&gt;&lt;\/b&gt; Endoscopic submucosal dissection (ESD) is an effective treatment for gastric superficial neoplasms and curative in 80-85% of the patients. The aims of this study were to identify risk factors for non-curative resection and metachronous development, and to evaluate patient management and outcome after non-curative resection. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; In this single-centre study, the outcome of consecutive patients submitted to gastric ESD was assessed during a minimum follow-up of 18 months. Univariate analysis and multivariate logistic regression were performed to identify risk factors. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; ESD was performed in 194 lesions (164 patients) between 2005 and 2014. The median follow-up was 40 months. En bloc and complete resection rates were 95.3 and 93.8%, respectively. Male sex, larger tumor size, longer procedural time, and more advanced histology were associated with a non-curative resection (&lt;i&gt;p&lt;\/i&gt; &lt; 0.05), but only carcinoma detected in biopsies before resection was identified as a significant risk factor on multivariate analysis. Metachronous lesions occurred in 18.4%, and the incidence rate was 4.7 lesions\/100 person-years. Older age at diagnosis was identified as the only predictor of metachronous development in logistic regression. In the non-curative resection group, survival did not differ between patients allocated to surveillance and those submitted to gastrectomy; 75% of gastrectomy specimens showed no residual lesion. &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; The risk factors identified for non-curative resection help to improve patient selection and patient information. Older patients had an increased risk for the development of metachronous lesions. In patients with non-curative resections, individualized patient management and surveillance seems to be an adequate option in selected cases.<\/jats:p>","DOI":"10.1159\/000450874","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T22:01:29Z","timestamp":1489528889000},"page":"31-39","source":"Crossref","is-referenced-by-count":32,"title":["Long-Term Outcomes of Gastric Endoscopic Submucosal Dissection: Focus on Metachronous and Non-Curative Resection Management"],"prefix":"10.1159","volume":"24","author":[{"given":"D.","family":"Lib\u00e2nio","sequence":"first","affiliation":[]},{"given":"P.","family":"Pimentel-Nunes","sequence":"additional","affiliation":[]},{"given":"L.P.","family":"Afonso","sequence":"additional","affiliation":[]},{"given":"R.","family":"Henrique","sequence":"additional","affiliation":[]},{"given":"M.","family":"Dinis-Ribeiro","sequence":"additional","affiliation":[]}],"member":"127","published-online":{"date-parts":[[2016,11,30]]},"container-title":["GE - Portuguese Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/450874","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/450874","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/450874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:16:33Z","timestamp":1745428593000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000450874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,30]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,1,18]]},"published-print":{"date-parts":[[2017,1,17]]}},"URL":"https:\/\/doi.org\/10.1159\/000450874","archive":["Portico"],"relation":{},"ISSN":["2341-4545","2387-1954"],"issn-type":[{"type":"print","value":"2341-4545"},{"type":"electronic","value":"2387-1954"}],"subject":[],"published":{"date-parts":[[2016,11,30]]}}}