Size discrepancy between endoscopic size and pathologic size is not negligible in endoscopic resection for early gastric cancer

Abstract

Larger size, flat/depressed type, and undifferentiated histology of EGC carry a significant risk for endoscopic underestimation of lesion size, which results in the lower rates of complete and curative resections for EGC. Further studies to reduce size discrepancy are warranted.

Diagnostic group classifications of gastric neoplasms by endoscopic resection criteria before and after treatment: real-world experience

“…In a recent evaluation of the endoscopic and the pathologic size, the median difference was 5 mm and the risk LGD low-grade dysplasia, HGD high-grade dysplasia, AI-EGC absolute indication early gastric cancer, EI-EGC expanded indication early gastric cancer, BEI-EGC beyond expanded indication early gastric cancer, ESD endoscopic submucosal dissection factors for size underestimation were larger lesion, flat/depressed type, and undifferentiated-type histology [10]. Determination of horizontal extent of the lesion is difficult for intestinal-type EGC in lesions with a flat component, large size, and moderately differentiated adenocarcinoma [25].…”

“…For example, the final histological diagnosis of 32-53 % of high-grade dysplasia is changed to gastric cancer after endoscopic resection [8,9]. Second, the lesion size measured before and after endoscopic resection may differ considerably [10]. Third, estimation of the depth of invasion before the treatment is not reliable, even after endoscopic ultrasonography [5].…”

The value of diagnostic endoscopic submucosal dissection for patients with clinical submucosal invasive early gastric cancer

“…Preoperative diagnoses are not always accurate. There are usually discrepancies between preoperative and postoperative tumor-size measurements, with tumor size often underestimated [13][14][15]. We limited the preoperative tumor size to less than 30 mm in diameter to satisfy the JCGA's curative resection criteria.…”

Difficulty of predicting the presence of lymph node metastases in patients with clinical early stage gastric cancer: a case control study

“…Tumor size was measured using both EGD and EUS. If lesion size was measured using both EGD and EUS, the larger measurement was recorded as the representative tumor size [ 17 , 18 ].…”