Endoscopy 2021; 53(S 01): S22
DOI: 10.1055/s-0041-1724308
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Thursday, 25 March 2021 16:00 – 16:45 Risk factor assessment for gastric cancer Room 5

Synchronous Gastric Neoplastic Lesions: Clinical analysis and Therapeutic Approach

M Rodríguez-Carrasco
1   Portuguese Oncology Institute of Porto, Gastroenterology Department, Porto, Portugal
,
D Libânio
1   Portuguese Oncology Institute of Porto, Gastroenterology Department, Porto, Portugal
2   Faculty of Medicine, University of Porto, MEDCIDS - Department of Community Medicine, Health Information and Decision, Porto, Portugal
,
P Pimentel-Nunes
1   Portuguese Oncology Institute of Porto, Gastroenterology Department, Porto, Portugal
2   Faculty of Medicine, University of Porto, MEDCIDS - Department of Community Medicine, Health Information and Decision, Porto, Portugal
3   Faculty of Medicine, University of Porto, Department of Surgery and Physiology, Porto, Portugal
,
LP Afonso
4   Portuguese Oncology Institute of Porto, Pathology Department, Porto, Portugal
,
P Monterio
4   Portuguese Oncology Institute of Porto, Pathology Department, Porto, Portugal
,
M Dinis-Ribeiro
1   Portuguese Oncology Institute of Porto, Gastroenterology Department, Porto, Portugal
2   Faculty of Medicine, University of Porto, MEDCIDS - Department of Community Medicine, Health Information and Decision, Porto, Portugal
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    Aims Synchronous gastric neoplastic lesions have been reported in up to 10.9 % of patients with gastric cancer and the most adequate strategy (simultaneous resection vs deferment) is unclear since safety and outcomes of the two strategies have been rarely evaluated. We aimed to analyse the prevalence of gastric synchronous lesions, possible risk factors for its diagnosis, and outcomes of simultaneous resection.

    Methods Retrospective study including data regarding endoscopic submucosal dissection (ESD) procedures performed between January/2005-May/2020 in our centre. Synchronous lesions detected prior/during ESD were defined as “detected-synchronous” (dSyn). Simultaneous resection was considered when ≥2 lesions were removed during the same procedure.

    Results In the 632 ESD, 10.9 % had synchronous lesions (54 (8.5 %) corresponding to dSyn and 15 (2.4 %) synchronous lesions detected during the 1st year of follow-up). The majority of dSyn had distal or middle location (55.5 % and 31.5 %, respectively) and morphology type 0-IIa/IIb or 0-II with depressed component (55.5 % and 26 %, respectively). Similarly, most of the missed lesions (93.3 %) had 0-IIa morphology and distal location (60 %). No factors related to patients nor primary-lesions showed a significant influence on the occurrence of synchronous. Among dSyn, the most common therapeutic approach was simultaneous resection (92.6%). No significant differences were found between both groups regarding R0, complication rate, procedural time, and hospitalization time. The reasons for deferments were lack of operational time (50 %) and suspicion of non-curative resection in the primary lesion (50 %, which had middle and distal location). Three of the four postponements underwent a second ESD and two met curative criteria. Accordingly, 50 % of the deferments could have benefited from simultaneous resection.

    Conclusions A careful endoscopic examination is essential to detect synchronous lesions, particularly those with 0-II with or without depressed component in morphology. Simultaneous gastric resection is safe, feasible, and may be advantageous for lesions without suspicion of deep invasion in primary lesion.

    Citation: Rodríguez-Carrasco M, Libânio D, Pimentel-Nunes P et al. OP48 SYNCHRONOUS GASTRIC NEOPLASTIC LESIONS: CLINICAL ANALYSIS AND THERAPEUTIC APPROACH. Endoscopy 2021; 53: S22.


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    Publication History

    Article published online:
    19 March 2021

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