Journal article
Factors Associated With Advanced Histological Diagnosis and Upstaging After Endoscopic Submucosal Dissection of Superficial Gastric Neoplasia
Techniques and innovations in gastrointestinal endoscopy, Vol.25(1), pp.2-10
2023
DOI: 10.1016/j.tige.2022.07.002
Abstract
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.
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.
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.
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.
Details
- Title: Subtitle
- Factors Associated With Advanced Histological Diagnosis and Upstaging After Endoscopic Submucosal Dissection of Superficial Gastric Neoplasia
- Creators
- Franciska J. Gudenkauf - Johns Hopkins HospitalAmit Mehta - Johns Hopkins HospitalLorenzo Ferri - Montreal General HospitalHiroyuki Aihara - Brigham and Women's HospitalPeter V. Draganov - AdventHealth OrlandoDennis J. Yang - AdventHealth OrlandoTerry L. Jue - Mayo Clinic in ArizonaCraig A. Munroe - University of California, San FranciscoEshandeep S. Boparai - Kaiser Permanente San Francisco Medical CenterNeal A. Mehta - Beth Israel Deaconess Medical CenterAmit Bhatt - Cleveland ClinicNikhil A. Kumta - Mount Sinai HospitalMohamed O. Othman - Baylor College of MedicineMichael Mercado - Baylor College of MedicineHuma Javaid - Baylor College of MedicineAbdul Aziz Aadam - Northwestern UniversityAmanda Siegel - Northwestern UniversityTheodore W. James - University of North Carolina at Chapel HillIan S. Grimm - University of North Carolina at Chapel HillJohn M. DeWitt - Indiana University – Purdue University IndianapolisAleksey Novikov - Thomas Jefferson UniversityAlexander Schlachterman - Thomas Jefferson UniversityThomas Kowalski - Thomas Jefferson UniversityJason Samarasena - University of California, IrvineRintaro Hashimoto - University of California, IrvineNabil El Hage Chehade - University of California, IrvineJohn G. Lee - University of California, IrvineKenneth Chang - University of California, IrvineBailey Su - University of ChicagoMichael B. Ujiki - NorthShore University HealthSystemReem Z. Sharaiha - Cornell UniversityDavid L. Carr-Locke - Weill Cornell MedicineAlex Chen - Montreal General HospitalMichael Chen - Montreal General HospitalYen-I Chen - McGill UniversityYutaka Tomizawa - University of WashingtonDaniel von Renteln - Division of Gastroenterology, Montreal University Medical Center and Research Center Montreal, Quebec, CanadaVivek Kumbhari - Mayo Clinic in FloridaMouen A. Khashab - Johns Hopkins HospitalRobert Bechara - Queen's UniversityMichael Karasik - Hartford HospitalNeej J. Patel - Mayo Clinic in ArizonaNorio Fukami - Mayo Clinic in ArizonaMakoto Nishimura - Memorial Sloan Kettering Cancer CenterYuri Hanada - Mayo ClinicLouis M Wong Kee Song - Mayo ClinicMonika Laszkowska - Memorial Sloan Kettering Cancer CenterAndrew Y. Wang - University of VirginiaJoo Ha Hwang - Stanford UniversityShai Friedland - Stanford UniversityAmrita Sethi - Columbia University Irving Medical CenterSaowanee Ngamruengphong - Johns Hopkins Hospital
- Resource Type
- Journal article
- Publication Details
- Techniques and innovations in gastrointestinal endoscopy, Vol.25(1), pp.2-10
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.tige.2022.07.002
- ISSN
- 2590-0307
- eISSN
- 2590-0307
- Language
- English
- Date published
- 2023
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984695834602771
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