Factors associated with advanced histological diagnosis and upstaging after endoscopic submucosal dissection of superficial gastric neoplasia Journal Article

  


Authors: Gudenkauf, F. J.; Mehta, A.; Ferri, L.; Aihara, H.; Draganov, P. V.; Yang, D. J.; Jue, T. L.; Munroe, C. A.; Boparai, E. S.; Mehta, N. A.; Bhatt, A.; Kumta, N. A.; Othman, M. O.; Mercado, M.; Javaid, H.; Aadam, A. A.; Siegel, A.; James, T. W.; Grimm, I. S.; DeWitt, J. M.; Novikov, A.; Schlachterman, A.; Kowalski, T.; Samarasena, J.; Hashimoto, R.; Chehade, N. E. H.; Lee, J. G.; Chang, K.; Su, B.; Ujiki, M. B.; Sharaiha, R. Z.; Carr-Locke, D. L.; Chen, A.; Chen, M.; Chen, Y. I.; Tomizawa, Y.; von Renteln, D.; Kumbhari, V.; Khashab, M. A.; Bechara, R.; Karasik, M.; Patel, N. J.; Fukami, N.; Nishimura, M.; Hanada, Y.; Song, L. M. W. K.; Laszkowska, M.; Wang, A. Y.; Hwang, J. H.; Friedland, S.; Sethi, A.; Ngamruengphong, S.
Article Title: Factors associated with advanced histological diagnosis and upstaging after endoscopic submucosal dissection of superficial gastric neoplasia
Abstract: Background and Aims: Endoscopic submucosal dissection (ESD) is an important treatment for gastric neoplasia. Some gastric adenomas with low-grade dysplasia (LGD) and high-grade dysplasia (HGD) on endoscopic forceps biopsy (EFB) are diagnosed as gastric adenocarcinoma (GAC) after ESD. We aimed to identify factors associated with histological diagnosis of gastric lesions and predictors for pathological upstaging following ESD. Methods: This retrospective study analyzed data from 309 patients who underwent gastric ESD at 25 tertiary care centers in North America. Variables assessed included demographic characteristics, endoscopic lesion characteristics, and histopathological diagnoses. We used logistic regression to identify predictors of GAC following ESD, as well as pathologic upstaging from EFB to ESD. Results: Four point one percent of all cases with LGD and 12.8% with HGD on EFB were upstaged to GAC after ESD. There were no significant predictors of pathologic upstaging. However, logistic regression revealed that age (odds ratio [OR] = 1.05, P < 0.01), the presence of ulceration (OR = 2.76, P < 0.01), and tumors located in the upper third (OR = 2.35, P = 0.01) or lower third of the stomach (OR = 1.92, P = 0.02) significantly predicted GAC. Conclusion: In this large North American cohort of patients treated with gastric ESD, we found that tumor location in the upper and lower thirds of the stomach, tumor ulceration, and patient age could predict GAC. Endoscopists should be cognizant of these characteristics as up to 16.9% of lesions may be upstaged to GAC. © 2022 Elsevier Inc.
Keywords: controlled study; human tissue; aged; major clinical study; histopathology; cancer localization; cancer staging; cancer diagnosis; cohort analysis; retrospective study; age; stomach ulcer; stomach cancer; north america; demographics; endoscopic submucosal dissection; stomach lesion; early gastric cancer; human; male; female; article; tertiary care center; therapeutic endoscopy; upstage diagnosis
Journal Title: Techniques and Innovations in Gastrointestinal Endoscopy
Volume: 25
Issue: 1
ISSN: 2666-5107
Publisher: Elsevier Inc.  
Date Published: 2023-01-01
Start Page: 2
End Page: 10
Language: English
DOI: 10.1016/j.tige.2022.07.002
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85136291227&doi=10.1016%2fj.tige.2022.07.002&partnerID=40&md5=745f723c0dbe14ab72ae472d22186e12
Notes: Article -- Export Date: 1 March 2023 -- Source: Scopus
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MSK Authors
  1. Makoto Nishimura
    56 Nishimura
  2. Monika Laszkowska
    37 Laszkowska
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