How Can We Predict the Presence of Missed Synchronous Lesions After Endoscopic Submucosal Dissection for Early Gastric Cancers or Gastric Adenomas?

Yoo, Jun Hwan; Shin, Sung Jae; Lee, Kee Myung; Choi, Jae Myoung; Wi, Jeong Ook; Kim, Dong Hoon; Lim, Sun Gyo; Hwang, Jae Chul; Cheong, Jae Youn; Yoo, Byung Moo; Lee, Kwang Jae; Kim, Jin Hong; Cho, Sung Won

doi:10.1097/mcg.0b013e31825c0b69

Cited by 26 publications

(26 citation statements)

References 22 publications

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“…The prevalence of synchronous lesions after endoscopic resection has been reported to be 2.0% to 11.6% [6-8]. The majority of studies reporting the prevalence and diagnosis of synchronous gastric neoplasms have focused on the prevalence after previous endoscopic examinations that were performed within a certain period of time [6,8-10].…”

Section: Introductionmentioning

confidence: 99%

“…The majority of studies reporting the prevalence and diagnosis of synchronous gastric neoplasms have focused on the prevalence after previous endoscopic examinations that were performed within a certain period of time [6,8-10]. Recently, one such study suggested that one-third of those lesions could have been detected during the previous endoscopic examinations [7].…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Missed Simultaneous Gastric Lesions Based on Double-Check Analysis of the Endoscopic Image

et al. 2017

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Background/AimsThe detection of multifocal lesions is important for the successful management of gastric neoplasms. We investigated the characteristics of missed simultaneous lesions and the reason for the missed diagnoses.MethodsA total of 140 patients who underwent repeat endoscopy before endoscopic resection between June 2013 and June 2014 were retrospectively reviewed. We classified simultaneous lesions into three groups based on a review of earlier images: group 1, no images of the location of simultaneous lesions were taken; group 2, no corresponding lesion was evident in the previous images; and group 3, simultaneous lesions were visible in the earlier images but a biopsy was not performed.ResultsSimultaneous lesions were found in 12 patients (8.6%) with 13 lesions, comprising 10 dysplasia (76.9%) and three adenocarcinoma (23.1%). Regarding the reasons for missed diagnoses, seven lesions (53.8%) were classified as group 3, five (38.5%) as group 1, and the remaining lesion (7.7%) as group 2. There were no significant differences in the characteristics of the patients with and without simultaneous lesions.ConclusionsLesions disregarded or unnoticed during endoscopic examination were the main reason for missed diagnosis of simultaneous lesions. Endoscopists should consider the possibility of simultaneous lesions and attempt to meticulously evaluate the entire gastric mucosa.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics of Missed Simultaneous Gastric Lesions Based on Double-Check Analysis of the Endoscopic Image

et al. 2017

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“…In some studies, SMEGC was defined as any second lesions that occurred within 6 months or 1 year after the initial diagnosis of EGC. [8,13,19] However, in the present study, SMEGC was defined as multiple EGC lesions that were found during treatment initially, based on the definition of “synchronous”; in other words, a time interval between lesions was not considered. This difference in the definition may have affected the SMEGC prevalence.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies that evaluated patients who underwent endoscopic resection, the predictive risk factors of SMEGC were reported to be male sex, undifferentiated histological type, and longitudinal location in the lower third. [11,13,14] In previous studies that evaluated patients who underwent surgical resection, the predictive risk factors of SMEGC were reported to be male sex, depth of invasion, elevated type of gross appearance, LVI, and differentiated histological type. [12,20] In some studies, older age was reported to be a predictive risk factor of SMEGC.…”

Section: Discussionmentioning

confidence: 99%

Predictive risk factors associated with synchronous multiple early gastric cancer

Jeong

An²,

Kwon

et al. 2017

Medicine

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The aim of this study was to elucidate the predictive risk factors of synchronous multiple early gastric cancer regardless of the treatment modality.Patients who underwent early gastric cancer treatment between July 2005 and June 2015 were retrospectively reviewed. In total, 1529 patients who were treated for early gastric cancer were included. We analyzed the patient's data to find predictive factors of synchronous multiple early gastric cancer compared to solitary early gastric cancer. Further analysis was performed to verify the difference between endoscopic and surgical treatment groups.Among the 1529 patients, synchronous multiple early gastric cancer was diagnosed in 68 (4.4%) patients. Significant differences in sex (P = .004), gross appearance (P = .038), depth of invasion (P = .007), and lymphovascular invasion (P = .039) were found between patients with solitary early gastric cancer and synchronous multiple early gastric cancer by univariate analysis. In multivariate analysis, male sex (odds ratio, 2.475; P = .011) and submucosal invasion (odds ratio, 1.850; P = .033) were independent predictive risk factors of synchronous multiple early gastric cancer. In addition, in multivariate analysis, significant differences in age, tumor size, longitudinal location, depth of invasion, and histology were found between patients groups depending on the mode of treatment.Male sex and submucosal invasion were predictive risk factors of synchronous multiple early gastric cancer. Patients with these factors should undergo more meticulous endoscopic surveillance.

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“…The development of gastric epithelial neoplasm is associated with atrophy or intestinal metaplasia of background mucosa; thus, synchronous multiple lesions are common. The prevalence of synchronous gastric cancer has been reported to range from 4.8% to 20.9% [1-7], and the prevalence of synchronous lesions after endoscopic resection has been reported to be 2.0% to 11.6% [8-10]. Missing synchronous lesions may lead to increased cost for additional procedures or even make the initial endoscopic treatment meaningless, especially when the missed lesion is located more proximally, requiring gastrectomy.…”

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confidence: 99%

Characteristics of Missed Synchronous Gastric Epithelial Neoplasms

Lee¹

2017

Clin Endosc

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How Can We Predict the Presence of Missed Synchronous Lesions After Endoscopic Submucosal Dissection for Early Gastric Cancers or Gastric Adenomas?

Abstract: Tumor number at the time of ESD and age could be predictive factors for the presence of missed synchronous lesions after ESD. Careful endoscopic surveillance should be performed after ESD for multiple lesions or for elderly patients.

Cited by 26 publications

References 22 publications

Characteristics of Missed Simultaneous Gastric Lesions Based on Double-Check Analysis of the Endoscopic Image

Characteristics of Missed Simultaneous Gastric Lesions Based on Double-Check Analysis of the Endoscopic Image

Predictive risk factors associated with synchronous multiple early gastric cancer

Characteristics of Missed Synchronous Gastric Epithelial Neoplasms

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