Clinical Control Study Of Endoscopic Mucosal Dissection And Surgical Treatment For Early Undifferentiated Gastric Cancer

Objective The treatment of ESD in differentiated early gastric cancer has been extensively studied and confirmed to be ideal.However,for some undifferentiated patients with early gastric cancer,the feasibility of ESD treatment is still controversial.In this study,we will evaluate the safety of ESD in the treatment of undifferentiated early gastric cancer through clinical data,prognosis and EORTC QLQ-C3 questionnaire.Methods From January 1,2015 to December 31,2020,a total of 4577 patients confirmed to be gastric cancer underwent electronic gastroscopy and gastric CT examination in our hospital were collected.A retrospective analysis was conducted on 277 patients with early undifferentiated gastric cancer who met the inclusion and exclusion criteria,including 252 patients in the operation group and 25 patients in the ESD group.By searching outpatient information and previous hospitalization data,tumor site,tumor size,metastasis and metastasis,immunohistochemistry,complications during and after surgical treatment,five-year survival rate and various general data obtained by telephone follow-up,etc.,To investigate the long-term efficacy of ESD and surgical treatment of undifferentiated EGCs that meet the criteria for curable excision,the European Quality of Life Questionnaire Core 30(EORTC QLQ-C30)was used to analyze the difference in quality of life between the two types of therapy.Result s According to the inclusion and exclusion criteria,a total of 277 patients were included in the study,including 180 males and 97 females.The incidence rate of males was significantly higher than that of females,with a ratio of1.86:1.Through the analysis of general basic data,the results showed that the age of patients in the surgical group was generally smaller than that in the ESD group,and the difference between the two groups was statistically significant(P<0.05).Through the analysis of the previous concomitant medical history of patients in the two groups,the results showed that the proportion of patients with COPD in the ESD group was significantly greater than that in the surgical group(P<0.05).Analysis results of short-term postoperative complications showed that the actual length of hospital stay in the ESD group was significantly reduced,and the incidence of pulmonary infection after surgery was significantly lower,with statistical significance(P<0.05),while the incidence of bleeding after surgery was significantly higher in the ESD group,with statistical difference(P<0.05).Survival analysis of 277 patients included in the study was performed by Kaplan-Meier method.The results showed that there was no statistical difference in postoperative RFS between the two groups,and the postoperative OS of the surgical group was better than that of the ESD group(P<0.05).The EORTC QLQ-C30 questionnaire was performed at the end of follow-up for all patients included in the study,and the t test was used to analyze the results.The results showed that the physical function and the overall status of the ESD group had significant advantages(P<0.05).Conclusion ESD treatment of UD-EGC has the characteristics of short hospital stay and quick recovery,which can significantly improve the postoperative quality of life of patients,but the long-term survival status is worse than that of surgical treatment.Therefore,ESD treatment of UD-EGC should be treated with caution.ESD treatment may be an option for older patients with UD-EGC or severe omo rbidities.