Outcomes of ESD for patients with early gastric cancer and comorbid liver cirrhosis: a propensity score analysis

Motohiko Kato, Tsutomu Nishida, Toshimitsu Hamasaki, Naoki Kawai, Toshiyuki Yoshio, Satoshi Egawa, Katsumi Yamamoto, Hideharu Ogiyama, Masato Komori, Masanori Nakahara, Takamasa Yabuta, Akihiro Nishihara, Yoshito Hayashi, Takuya Yamada, Tetsuo Takehara

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Background: Gastric cancer and liver cirrhosis (LC) are often comorbid. However, little is known about the clinical outcomes of gastric endoscopic submucosal dissection (ESD) in patients with comorbid LC. Methods: This case–control study used a multicentre retrospective cohort. We identified 69 LC patients from the cohort of patients with early gastric cancer, who underwent gastric ESD at 12 hospitals from March 2003 to November 2010. Using the propensity score matching method, 69 patients without LC were used to compare the short- and long-term outcomes of ESD. Results: Among the 69 LC patients, 53 (77 %) were Child-Pugh grade A (CP-A) and 16 (28 %) had past or present histories of hepatocellular carcinoma (HCC). Short-term outcomes did not differ between the LC patients and controls or between the CP-A and CP-B/C patients. Although the LC patients had significantly worse long-term outcomes than the controls (the 5-year overall survival rates were 60 vs. 91 %, respectively), patients with CP-A liver function without HCC histories had an overall survival almost equivalent to that of patients without LC (controls). Conclusions: LC patients appear to be good candidates for ESD if they have CP-A liver function and no history of HCC. Although their short-term outcomes were not inferior, the patients with Child-Pugh grades B/C or with histories of HCC benefited less from ESD.

Original languageEnglish
Pages (from-to)1560-1566
Number of pages7
JournalSurgical endoscopy
Issue number6
Publication statusPublished - 2015 Jun 1
Externally publishedYes


  • ESD
  • Liver cirrhosis
  • Outcomes

ASJC Scopus subject areas

  • Surgery


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