Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Nationwide Survey on Endoscopic Submucosal Dissection for Early Gastric Cancer in Korea: Results From the Korean College of Helicobacter and Upper Gastrointestinal Research (KCHUGR) 2023 Survey

  • Jae Yong Park (Division of Gastroenterology, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Jeong Hoon Lee (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Tae-Se Kim (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Da Hyun Jung (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Bong Eun Lee (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Yonghoon Choi (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Wan-Sik Lee (Department of Internal Medicine, Chonnam Medical University Hwasun Hospital) ;
  • Young-Il Kim (Center for Gastric Cancer, National Cancer Center) ;
  • Sun Hyung Kang (Department of Internal Medicine, Chungnam National University College of Medicine) ;
  • Hyunsoo Chung (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Su Jin Kim (Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Joon Sung Kim (Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Donghoon Kang (Department of Internal medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Su Youn Nam (Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Seung Han Kim (Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Hyo-Joon Yang (Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Hyun Lim (Department of Gastroenterology, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Jin Lee (Division of Gastroenterology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Seon-Young Park (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Seung-Woo Lee (Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Sun Moon Kim (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Sam Ryong Jee (Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Dae Young Cheung (Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chung Hyun Tae (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
  • Seokin Kang (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Sung Chul Park (Department of Internal Medicine, Kangwon National University College of Medicine) ;
  • Seung In Seo (Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Cheol Min Shin (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kee Don Choi (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jong Yeul Lee (Center for Gastric Cancer, National Cancer Center) ;
  • The Research Management Committee of the Korean College of Helicobacter and Upper Gastrointestinal Research (Korean College of Helicobacter and Upper Gastrointestinal Research)
  • Received : 2026.03.01
  • Accepted : 2026.03.09
  • Published : 2026.04.01
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Abstract

Purpose: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Materials and Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes. Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5,460 ESD cases from 5,250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions: This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.

Keywords

Acknowledgement

We thank all of the participating institutions for their contributions to data collection. This nationwide survey was initiated and coordinated by the KCHUGR.

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