TY - JOUR
T1 - Factors Associated With Advanced Histological Diagnosis and Upstaging After Endoscopic Submucosal Dissection of Superficial Gastric Neoplasia
AU - Gudenkauf, Franciska J.
AU - Mehta, Amit
AU - Ferri, Lorenzo
AU - Aihara, Hiroyuki
AU - Draganov, Peter V.
AU - Yang, Dennis J.
AU - Jue, Terry L.
AU - Munroe, Craig A.
AU - Boparai, Eshandeep S.
AU - Mehta, Neal A.
AU - Bhatt, Amit
AU - Kumta, Nikhil A.
AU - Othman, Mohamed O.
AU - Mercado, Michael
AU - Javaid, Huma
AU - Aadam, Abdul Aziz
AU - Siegel, Amanda
AU - James, Theodore W.
AU - Grimm, Ian S.
AU - DeWitt, John M.
AU - Novikov, Aleksey
AU - Schlachterman, Alexander
AU - Kowalski, Thomas
AU - Samarasena, Jason
AU - Hashimoto, Rintaro
AU - Chehade, Nabil El Hage
AU - Lee, John G.
AU - Chang, Kenneth
AU - Su, Bailey
AU - Ujiki, Michael B.
AU - Sharaiha, Reem Z.
AU - Carr-Locke, David L.
AU - Chen, Alex
AU - Chen, Michael
AU - Chen, Yen I.
AU - Tomizawa, Yutaka
AU - von Renteln, Daniel
AU - Kumbhari, Vivek
AU - Khashab, Mouen A.
AU - Bechara, Robert
AU - Karasik, Michael
AU - Patel, Neej J.
AU - Fukami, Norio
AU - Nishimura, Makoto
AU - Hanada, Yuri
AU - Song, Louis M.Wong Kee
AU - Laszkowska, Monika
AU - Wang, Andrew Y.
AU - Hwang, Joo Ha
AU - Friedland, Shai
AU - Sethi, Amrita
AU - Ngamruengphong, Saowanee
N1 - Funding Information:
Conflicts of Interest These authors disclose the following: Amrita Sethi is a consultant for BSC, Olympus, Medtronic, Fujifilm, Microtech, and Intuitive Surgical. Amit Bhatt is a consultant for Boston Scientific, Olympus, Lumendi, and Medtronic and receives royalties from Medtronic. Nikhil A. Kumta is a consultant for Apollo Endosurgery, Boston Scientific, Olympus, Medtronic, SafeHeal, and Intuitive Surgical. Mouen A. Khashab is on the medical advisory board for Boston Scientific and Olympus America and is a consultant for Boston Scientific, Olympus America, and Medtronic. Dennis Yang is consultant for Olympus America, Boston Scientific, Lumendi and Steris. Peter V. Draganov is consultant for Boston Scientific, Lumendi, Cook, Olympus and Microtech. Vivek Kumbhari is a consultant for Medtronic, Boston Scientific, FujiFilm, and Apollo Endosurgery. He also receives research support from ERBE and is a board member for Bariatek and the Association for Bariatric Endoscopy. Saowanee Ngamruengphong is a consultant for Boston Scientific. Yen-I Chen is a consultant for Boston Scientific. Daniel von Renteln has received research funding from ERBE, Boston Scientific, Pendopharm, Pentax, and Fuji; is a consultant for Boston Scientific and Pendopharm; serves as speaker honoraria for Boston Scientific, Pendopharm, and ERBE; and has a conflict of interest with Arms Length. Hiroyuki Aihara is a consultant for Olympus America, Boston Scientific, Fujifilm Medical Systems, Medtronic, ConMed, Auris Health, Lumendi, and 3D Matrix. Michael B. Ujiki is a consultant for Olympus, Cook, Gore, and Boston Scientific. He is a speaker for Medtronic and Apollo. Ian Grimm is a consultant for Boston Scientific. Mohamed O. Othman is a consultant for BSC, Olympus, Conmed, Lumendi, Medtronic, Nestle, and Abbvie. Reem Z. Sharaiha is a consultant for Boston Scientific and Apollo Endosurgery. Kenneth Chang is a consultant for and/or grant recipient from Apollo, Boston Scientific, ERBE, C2 Therapeutics, Cook, Covidien, Endogastric Solutions, Mederi, Medtronic, Olympus, Ovesco, Pentax, and Torax. Norio Fukami is a consultant for Boston Scientific and Olympus America. Makoto Nishimura is a consultant for Boston Scientific, Olympus America, and Lumendi. John M DeWitt is a consultant for Boston Scientific and Vyaire Medical, Inc. Alexander Schlachterman is a consultant for Medtronic, FujiFilm, Olympus, and Lumendi. Thomas Kowalski is a consultant for BSCI, Olympus, and Medtronics. Jason Samarasena is a consultant for Conmed, Medtronic, Olympus, Mauna Kea, Steris, and Neptune Medical and holds ownership in Docbot. Yutaka Tomizawa is a consultant for Medtronic. Louis M. Wong Kee Song is a consultant for Olympus America and Steris. Joo Ha Hwang is a consultant for Olympus, Boston Scientific, Medtronic, Fujifilm, Steris, Lumendi, and MicroTech. The remaining authors disclose no conflicts. Funding None.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/1
Y1 - 2023/1
N2 - 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.
AB - 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.
KW - Early gastric cancer
KW - Therapeutic endoscopy
KW - Upstage diagnosis
UR - http://www.scopus.com/inward/record.url?scp=85136291227&partnerID=8YFLogxK
U2 - 10.1016/j.tige.2022.07.002
DO - 10.1016/j.tige.2022.07.002
M3 - Article
AN - SCOPUS:85136291227
SN - 2666-5107
VL - 25
SP - 2
EP - 10
JO - Techniques and Innovations in Gastrointestinal Endoscopy
JF - Techniques and Innovations in Gastrointestinal Endoscopy
IS - 1
ER -