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- Title
Impact of endoscopic surveillance on the early diagnosis and endoscopic resection likelihood of gastric cancer.
- Authors
Sun, Lu; Shen, Yanjie; Huang, Liang; Zhao, Jing; Li, Meng; Hu, Yue; Lyu, Bin
- Abstract
Background: Endoscopy could help detect early gastric cancer (EGC) and improve the prognosis of patients. The aim of this study was to analyze the impact of endoscopy and endoscopic surveillance on the early detection of gastric cancer (GC), GC staging, and treatment selection. Methods: Patients with GC diagnosed at our center from 2010 to 2022 were retrospectively analyzed and allocated to the short-interval group (had received endoscopy within 3 years before diagnosis), the long-interval group (had received endoscopy more than 3 years before diagnosis), and the unchecked group (had not received endoscopy before diagnosis). The differences in GC staging and treatment modalities among the three groups were analyzed, and the differences in the clinical and pathological features of EGC were further analyzed. Results: One thousand and twenty-five GC patients were included, with 395 cases of EGC and 630 cases of advanced GC. The proportions of EGC in the short-interval, long-interval, and unchecked groups were 98.0%, 84.2%, and 29.8%, respectively (p < 0.001). Among the 387 lesions of 367 EGC patients were resected by endoscopic submucosal dissection (ESD), 341 (88.1%) exhibited curative resection, and 46 (11.9%) involved noncurative resections. Lesions of EGC differed significantly in diameter, depth of invasion, and curative resection rate (p = 0.033, 0.019, and 0.005, respectively). In the short-interval group, 87.8% of the lesions were ≤ 2 cm, 95.6% of the invasion depths were confined to the mucosal layer, and 96.7% of the eCura scores were A or B. Compared with the unchecked group, they had smaller diameters (RR = 0.419, 95% CI 0.234–0.752), shallower invasion depths (RR = 0.286, 95% CI 0.105–0.777), and a higher curative resection rate (RR = 0.215, 95% CI 0.068–0.676). Conclusion: Endoscopic surveillance at 3-year intervals can help detect EGC, and the EGC lesions found have smaller diameters and shallower depths of invasion, helping improve the curative resection rate of ESD.
- Subjects
CHINA; PUBLIC health surveillance; PATIENT selection; STOMACH tumors; EARLY medical intervention; ACADEMIC medical centers; T-test (Statistics); RESEARCH funding; EARLY detection of cancer; STOMACH; KRUSKAL-Wallis Test; FISHER exact test; TREATMENT effectiveness; CANCER patients; RETROSPECTIVE studies; MANN Whitney U Test; CHI-squared test; DESCRIPTIVE statistics; RELATIVE medical risk; DIGESTIVE organ surgery; ENDOSCOPIC gastrointestinal surgery; MEDICAL records; ACQUISITION of data; ONE-way analysis of variance; TUMOR classification; CONFIDENCE intervals; DATA analysis software
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2024, Vol 38, Issue 4, p2188
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-024-10748-4