Abstract：
BACKGROUND: A small portion of patients are diagnosed with early gastric cancer (EGC) and undergo endoscopic submucosal dissection (ESD) at a young age. However, their clinical outcomes are rarely known.
OBJECTIVE: We investigated to identify the feasibility and clinical outcomes of ESD for EGC focusing on young patients.
METHODS: We analyzed the clinical characteristics and outscomes of patients who had undergone ESD for the treatment of EGC at < 50 years of age. We enrolled patients who had been diagnosed with EGC and had undergone ESD between 2006 and 2020. We divided them by age as follows: ≤ 50 and > 50 years into the young age (YA) and other age (OA) groups, respectively.
RESULTS: Altogether, 1681 patients underwent ESD for EGC (YA group: 124 [7.4%], OA group: 1557 [92.6%]). The YA group had less severe atrophy and more undifferentiated (37.1% vs. 13.9%, P < 0.001) and diffuse type (25% vs. 7.7%, P < 0.001) histology. The curative resection rate was not significantly different between the groups. However, among 1075 patients who had achieved curative resection and had been followed-up for > 12 months, the YA group had a lower incidence of MGN (5.2% vs. 17.5%, P = 0.004) and MGC (2.6% vs. 10.9%, P = 0.019) than those exhibited by the OA group. The YA group was a significant negative predictor of MGN (odds ratio [OR]: 2.983, 95% confidence interval [CI] 1.060-8.393, P = 0.038), and marginally negative predictor in MGC (OR: 3.909, 95% CI: 0.939-16.281, P = 0.061).
CONCLUSIONS: ESD is a favorable and effective therapeutic modality for EGC patients aged < 50 years, once curative resection is achieved.
OBJECTIVE: We investigated to identify the feasibility and clinical outcomes of ESD for EGC focusing on young patients.
METHODS: We analyzed the clinical characteristics and outscomes of patients who had undergone ESD for the treatment of EGC at < 50 years of age. We enrolled patients who had been diagnosed with EGC and had undergone ESD between 2006 and 2020. We divided them by age as follows: ≤ 50 and > 50 years into the young age (YA) and other age (OA) groups, respectively.
RESULTS: Altogether, 1681 patients underwent ESD for EGC (YA group: 124 [7.4%], OA group: 1557 [92.6%]). The YA group had less severe atrophy and more undifferentiated (37.1% vs. 13.9%, P < 0.001) and diffuse type (25% vs. 7.7%, P < 0.001) histology. The curative resection rate was not significantly different between the groups. However, among 1075 patients who had achieved curative resection and had been followed-up for > 12 months, the YA group had a lower incidence of MGN (5.2% vs. 17.5%, P = 0.004) and MGC (2.6% vs. 10.9%, P = 0.019) than those exhibited by the OA group. The YA group was a significant negative predictor of MGN (odds ratio [OR]: 2.983, 95% confidence interval [CI] 1.060-8.393, P = 0.038), and marginally negative predictor in MGC (OR: 3.909, 95% CI: 0.939-16.281, P = 0.061).
CONCLUSIONS: ESD is a favorable and effective therapeutic modality for EGC patients aged < 50 years, once curative resection is achieved.
摘要：
背景：一小部分患者被诊断为早期胃癌（EGC），并在年轻时接受内镜黏膜下剥离术（ESD）。然而,其临床结局鲜为人知.
目的：我们研究了以年轻患者为重点的EGCESD的可行性和临床结局。
方法：我们分析了<50岁接受ESD治疗EGC患者的临床特征和结果。我们招募了在2006年至2020年之间被诊断为EGC并接受ESD的患者。我们将它们按年龄划分如下：≤50岁和>50岁分为年轻年龄（YA）和其他年龄（OA）组，分别。
结果：总之，1681例患者因EGC接受ESD（YA组：124[7.4%]，OA组：1557[92.6%])。YA组萎缩程度较轻，未分化程度较高(37.1%vs.13.9%,P<0.001）和弥漫型（25%vs.7.7%,P<0.001)组织学。两组之间的治愈性切除率没有显着差异。然而,在1075例获得治愈性切除且随访时间>12个月的患者中，YA组MGN发生率较低(5.2%vs.17.5%,P=0.004）和MGC（2.6%与10.9%,P=0.019）比OA组表现出的那些。YA组是MGN的显著负预测因子(比值比[OR]:2.983,95%置信区间[CI]1.060-8.393,P=0.038),MGC中的阴性预测因子（OR：3.909，95％CI：0.939-16.281，P=0.061）。
结论：ESD对<50岁的EGC患者是一种有利且有效的治疗方式，一旦治愈性切除。
目的：我们研究了以年轻患者为重点的EGCESD的可行性和临床结局。
方法：我们分析了<50岁接受ESD治疗EGC患者的临床特征和结果。我们招募了在2006年至2020年之间被诊断为EGC并接受ESD的患者。我们将它们按年龄划分如下：≤50岁和>50岁分为年轻年龄（YA）和其他年龄（OA）组，分别。
结果：总之，1681例患者因EGC接受ESD（YA组：124[7.4%]，OA组：1557[92.6%])。YA组萎缩程度较轻，未分化程度较高(37.1%vs.13.9%,P<0.001）和弥漫型（25%vs.7.7%,P<0.001)组织学。两组之间的治愈性切除率没有显着差异。然而,在1075例获得治愈性切除且随访时间>12个月的患者中，YA组MGN发生率较低(5.2%vs.17.5%,P=0.004）和MGC（2.6%与10.9%,P=0.019）比OA组表现出的那些。YA组是MGN的显著负预测因子(比值比[OR]:2.983,95%置信区间[CI]1.060-8.393,P=0.038),MGC中的阴性预测因子（OR：3.909，95％CI：0.939-16.281，P=0.061）。
结论：ESD对<50岁的EGC患者是一种有利且有效的治疗方式，一旦治愈性切除。
