Hyeong Seok Nam1, Cheol Woong Choi2, Su Jin Kim1, Dae Hwan Kang1, Hyung Wook Kim1, Su Bum Park1, Dae Gon Ryu1. 1. Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Yangsan, Gyeongsangnam, 50612, South Korea. 2. Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Yangsan, Gyeongsangnam, 50612, South Korea. drluckyace@gmail.com.
Abstract
BACKGROUND AND STUDY AIMS: The management plan for gastric indefinite for neoplasia is undetermined, and endoscopic forceps biopsy might be inconclusive in ascertaining whether a resection is required. This study aimed to evaluate the clinical outcomes of endoscopic submucosal dissection (ESD) for gastric indefinite for neoplasia and to identify the factors highly predictive of true neoplasia. PATIENTS AND METHODS: This retrospective study was conducted in a single, tertiary, referral hospital between November 2008 and December 2015. A total of 109 gastric indefinite for neoplasia lesions from endoscopic forceps biopsy that were resected by ESD were included in the study. The clinical outcomes and endoscopic factors for prediction of true neoplasia were analyzed. RESULTS: A total of 99 patients (90.8%) were diagnosed with definite neoplasia after ESD and were classified as category 3 (n = 42), category 4 (n = 50), and category 5 (n = 7) according to the revised Vienna classification. The mean age of the patients was 65.8 ± 9.8 years. The mean lesion size was 10.7 ± 6.1 mm. The patient population predominantly consisted of male patients (70.6%). The en bloc and complete endoscopic resection rates were 98.2% and 94.5%, respectively. Factors associated with true neoplastic lesions were male sex (odds ratio [OR] 8.596, p = 0.008) and lesion size ≥ 5 mm (OR 11.355, p = 0.003). Factors associated with category 4-5 were male sex (OR 3.165, p = 0.021) and erosive change (OR 2.841, p = 0.031). CONCLUSIONS: Endoscopic resection for indefinite for neoplasia with larger lesions size and erosive changes, especially in males, should be considered when possible.
BACKGROUND AND STUDY AIMS: The management plan for gastric indefinite for neoplasia is undetermined, and endoscopic forceps biopsy might be inconclusive in ascertaining whether a resection is required. This study aimed to evaluate the clinical outcomes of endoscopic submucosal dissection (ESD) for gastric indefinite for neoplasia and to identify the factors highly predictive of true neoplasia. PATIENTS AND METHODS: This retrospective study was conducted in a single, tertiary, referral hospital between November 2008 and December 2015. A total of 109 gastric indefinite for neoplasia lesions from endoscopic forceps biopsy that were resected by ESD were included in the study. The clinical outcomes and endoscopic factors for prediction of true neoplasia were analyzed. RESULTS: A total of 99 patients (90.8%) were diagnosed with definite neoplasia after ESD and were classified as category 3 (n = 42), category 4 (n = 50), and category 5 (n = 7) according to the revised Vienna classification. The mean age of the patients was 65.8 ± 9.8 years. The mean lesion size was 10.7 ± 6.1 mm. The patient population predominantly consisted of male patients (70.6%). The en bloc and complete endoscopic resection rates were 98.2% and 94.5%, respectively. Factors associated with true neoplastic lesions were male sex (odds ratio [OR] 8.596, p = 0.008) and lesion size ≥ 5 mm (OR 11.355, p = 0.003). Factors associated with category 4-5 were male sex (OR 3.165, p = 0.021) and erosive change (OR 2.841, p = 0.031). CONCLUSIONS: Endoscopic resection for indefinite for neoplasia with larger lesions size and erosive changes, especially in males, should be considered when possible.
Authors: Ahmedin Jemal; Melissa M Center; Carol DeSantis; Elizabeth M Ward Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-07-20 Impact factor: 4.254
Authors: D I Park; P L Rhee; J E Kim; J G Hyun; Y H Kim; H J Son; J J Kim; S W Paik; J C Rhee; K W Choi; Y L Oh Journal: Endoscopy Date: 2001-06 Impact factor: 10.093
Authors: Ji Ha Kim; Hyeong Seok Nam; Cheol Woong Choi; Dae Hwan Kang; Hyung Wook Kim; Su Bum Park; Su Jin Kim; Sun Hwi Hwang; Si Hak Lee Journal: Surg Endosc Date: 2016-08-05 Impact factor: 4.584