Comparison of treatment strategies for submucosal tumors originating from the muscularis propria at esophagogastric junction or cardia

Table 2 Peri-operative clinical outcomes, n (%)

	ESD (n = 15)	STER (n = 10)	LWR (n = 25)	P value
En bloc resection	15 (100.0)	10 (100.0)	25 (100.0)	1.000
Macroscopic complete resection1	15 (100.0)	10 (100.0)	25 (100.0)	1.000
Microscopic complete resection2				0.021
R0 resection	13 (86.7)	6 (60.0)	24 (96)
R1 resection	2 (13.3)	4 (40.0)	1 (4.0)
Pathological diagnosis				< 0.001
Leiomyoma	10 (66.7)	9 (90.0)	8 (32.0)
GIST with low-risk3	3 (20.0)	0 (0.0)	0 (0.0)
GIST with intermediate to high-risk4	2 (13.3)	1 (10.0)	17 (68.0)
Total procedure time, minutes, median (IQR)	75.0 (65.0-100.0)	84.0 (73.0-92.0)	70.0 (55.0-80.0)	0.075
Hospital stay, days, median (IQR)	6.0 (5.0-7.0)	6.0 (6.0-9.0)	5.0 (4.0-6.0)	0.017
Fasting duration, days, median (IQR)	2.0 (2.0-5.0)	3.0 (3.0-4.0)	1.0 (1.0-1.0)	< 0.001
Long diameter of tumor in pathology, mm, median (IQR)	27.0 (15.5-35.0)	28.5 (25.0-45.0)	36.0 (27.0-45.0)	0.002
Complications
Delayed bleeding	2 (13.3)	0 (0.0)	1 (4.0)	0.325
Pneumoperitoneum5	2 (13.3)	0 (0.0)	1 (4.0)	0.325
Peritonitis	0 (0.0)	0 (0.0)	0 (0.0)	1.000

¹Macroscopic complete resection was defined as both lateral and basal margins appearing lesion-free during the procedure.

²R0 resection was defined as both lateral and basal margins being lesion-free.

³The size is less than 2 cm, and the mitotic count is less than 5 per 50 high-power fields.

⁴The size is 2 cm or larger, or the mitotic count is 5 or more per 50 high-power fields.

⁵Free air is visible on the X-ray image, and air is removed via needle aspiration.

ESD: Endoscopic submucosal dissection; STER: Submucosal tunneling endoscopic resection; LWR: Laparoscopic wedge resection; GIST: Gastrointestinal stromal tumor; IQR: Interquartile range.