Factors Associated With Advanced Histological Diagnosis and Upstaging After Endoscopic Submucosal Dissection of Superficial Gastric Neoplasia

Franciska J. Gudenkauf; Amit Mehta; Lorenzo Ferri; Hiroyuki Aihara; Peter V. Draganov; Dennis J. Yang; Terry L. Jue; Craig A. Munroe; Eshandeep S. Boparai; Neal A. Mehta; Amit Bhatt; Nikhil A. Kumta; Mohamed O. Othman; Michael Mercado; Huma Javaid; Abdul Aziz Aadam; Amanda Siegel; Theodore W. James; Ian S. Grimm; John M. DeWitt; Aleksey Novikov; Alexander Schlachterman; Thomas Kowalski; Jason Samarasena; Rintaro Hashimoto; Nabil El Hage Chehade; John G. Lee; Kenneth Chang; Bailey Su; Michael B. Ujiki; Reem Z. Sharaiha; David L. Carr-Locke; Alex Chen; Michael Chen; Yen I. Chen; Yutaka Tomizawa; Daniel von Renteln; Vivek Kumbhari; Mouen A. Khashab; Robert Bechara; Michael Karasik; Neej J. Patel; Norio Fukami; Makoto Nishimura; Yuri Hanada; Louis M.Wong Kee Song; Monika Laszkowska; Andrew Y. Wang; Joo Ha Hwang; Shai Friedland; Amrita Sethi; Saowanee Ngamruengphong

doi:10.1016/j.tige.2022.07.002

Factors Associated With Advanced Histological Diagnosis and Upstaging After Endoscopic Submucosal Dissection of Superficial Gastric Neoplasia

Franciska J. Gudenkauf, Amit Mehta, Lorenzo Ferri, Hiroyuki Aihara, Peter V. Draganov, Dennis J. Yang, Terry L. Jue, Craig A. Munroe, Eshandeep S. Boparai, Neal A. Mehta, Amit Bhatt, Nikhil A. Kumta, Mohamed O. Othman, Michael Mercado, Huma Javaid, Abdul Aziz Aadam, Amanda Siegel, Theodore W. James, Ian S. Grimm, John M. DeWittAleksey Novikov, Alexander Schlachterman, Thomas Kowalski, Jason Samarasena, Rintaro Hashimoto, Nabil El Hage Chehade, John G. Lee, Kenneth Chang, Bailey Su, Michael B. Ujiki, Reem Z. Sharaiha, David L. Carr-Locke, Alex Chen, Michael Chen, Yen I. Chen, Yutaka Tomizawa, Daniel von Renteln, Vivek Kumbhari, Mouen A. Khashab, Robert Bechara, Michael Karasik, Neej J. Patel, Norio Fukami, Makoto Nishimura, Yuri Hanada, Louis M.Wong Kee Song, Monika Laszkowska, Andrew Y. Wang, Joo Ha Hwang, Shai Friedland, Amrita Sethi, Saowanee Ngamruengphong

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	2-10
Number of pages	9
Journal	Techniques and Innovations in Gastrointestinal Endoscopy
Volume	25
Issue number	1
DOIs	https://doi.org/10.1016/j.tige.2022.07.002
State	Published - Jan 2023

Keywords

Early gastric cancer
Therapeutic endoscopy
Upstage diagnosis

Access to Document

10.1016/j.tige.2022.07.002

Cite this

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., ... Ngamruengphong, S. (2023). Factors Associated With Advanced Histological Diagnosis and Upstaging After Endoscopic Submucosal Dissection of Superficial Gastric Neoplasia. Techniques and Innovations in Gastrointestinal Endoscopy, 25(1), 2-10. https://doi.org/10.1016/j.tige.2022.07.002

@article{31544673142f4a4d96a08d4848a7e3ea,

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.",

keywords = "Early gastric cancer, Therapeutic endoscopy, Upstage diagnosis",

author = "Gudenkauf, {Franciska J.} and Amit Mehta and Lorenzo Ferri and Hiroyuki Aihara and Draganov, {Peter V.} and Yang, {Dennis J.} and Jue, {Terry L.} and Munroe, {Craig A.} and Boparai, {Eshandeep S.} and Mehta, {Neal A.} and Amit Bhatt and Kumta, {Nikhil A.} and Othman, {Mohamed O.} and Michael Mercado and Huma Javaid and Aadam, {Abdul Aziz} and Amanda Siegel and James, {Theodore W.} and Grimm, {Ian S.} and DeWitt, {John M.} and Aleksey Novikov and Alexander Schlachterman and Thomas Kowalski and Jason Samarasena and Rintaro Hashimoto and Chehade, {Nabil El Hage} and Lee, {John G.} and Kenneth Chang and Bailey Su and Ujiki, {Michael B.} and Sharaiha, {Reem Z.} and Carr-Locke, {David L.} and Alex Chen and Michael Chen and Chen, {Yen I.} and Yutaka Tomizawa and {von Renteln}, Daniel and Vivek Kumbhari and Khashab, {Mouen A.} and Robert Bechara and Michael Karasik and Patel, {Neej J.} and Norio Fukami and Makoto Nishimura and Yuri Hanada and Song, {Louis M.Wong Kee} and Monika Laszkowska and Wang, {Andrew Y.} and Hwang, {Joo Ha} and Shai Friedland and Amrita Sethi and Saowanee Ngamruengphong",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",

year = "2023",

month = jan,

doi = "10.1016/j.tige.2022.07.002",

language = "English",

volume = "25",

pages = "2--10",

journal = "Techniques and Innovations in Gastrointestinal Endoscopy",

issn = "2666-5107",

publisher = "Elsevier BV",

number = "1",

}

Gudenkauf, FJ, Mehta, A, Ferri, L, Aihara, H, Draganov, PV, Yang, DJ, Jue, TL, Munroe, CA, Boparai, ES, Mehta, NA, Bhatt, A, Kumta, NA, Othman, MO, Mercado, M, Javaid, H, Aadam, AA, Siegel, A, James, TW, Grimm, IS, DeWitt, JM, Novikov, A, Schlachterman, A, Kowalski, T, Samarasena, J, Hashimoto, R, Chehade, NEH, Lee, JG, Chang, K, Su, B, Ujiki, MB, Sharaiha, RZ, Carr-Locke, DL, Chen, A, Chen, M, Chen, YI, Tomizawa, Y, von Renteln, D, Kumbhari, V, Khashab, MA, Bechara, R, Karasik, M, Patel, NJ, Fukami, N, Nishimura, M, Hanada, Y, Song, LMWK, Laszkowska, M, Wang, AY, Hwang, JH, Friedland, S, Sethi, A & Ngamruengphong, S 2023, 'Factors Associated With Advanced Histological Diagnosis and Upstaging After Endoscopic Submucosal Dissection of Superficial Gastric Neoplasia', Techniques and Innovations in Gastrointestinal Endoscopy, vol. 25, no. 1, pp. 2-10. https://doi.org/10.1016/j.tige.2022.07.002

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

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 -

Factors Associated With Advanced Histological Diagnosis and Upstaging After Endoscopic Submucosal Dissection of Superficial Gastric Neoplasia

Abstract

Keywords

Access to Document

Fingerprint

Cite this