Endoscopy 2018; 50(04): S13
DOI: 10.1055/s-0038-1637061
ESGE Days 2018 oral presentations
20.04.2018 – Best care session 1
Georg Thieme Verlag KG Stuttgart · New York

ASSOCIATED FACTORS WITH OVERLOOKED NEOPLASIA AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION

CW Choi
1   Pusan National University School of Medicine, Yangsan, Korea, Republic of
,
DH Kang
1   Pusan National University School of Medicine, Yangsan, Korea, Republic of
,
HW Kim
1   Pusan National University School of Medicine, Yangsan, Korea, Republic of
,
SJ Kim
1   Pusan National University School of Medicine, Yangsan, Korea, Republic of
,
BJ Kwon
1   Pusan National University School of Medicine, Yangsan, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Since endoscopic submucosal dissection (ESD) has been accepted treatment choice for early gastric cancer (EGC) without risk of lymph node metastasis, missed gastric epithelial neoplasia at the time of ESD is not infrequent in the clinical practice. Knowledge about the risk factors associated with overlooked gastric epithelial neoplasia is important to provide optimal treatment.

Methods:

Between November 2008 and October 2014, a retrospective study was conducted in a single tertiary referral hospital. Consecutive patients who underwent ESD because of EGC or high grade dysplasia were analyzed to know the incidence of overlooked gastric superficial neoplasia and the associated factors.

Results:

A total of 488 patients met the inclusion criteria. Synchronous lesions were detected in the 59 patients (12.1%) during mean of 37.7 month. Among 77 synchronous lesions, 25 lesions (32.4%) were over-looked at the time of initial ESD. Age ≥65 years, moderate to severe endoscopic atrophic gastritis and elevated morphology of primary lesions were associated with the presence of synchronous gastric epithelial neoplasia. Non-elevated morphology of synchronous lesion was associated with overlooked lesions.

Conclusions:

Careful endoscopic examinations should be needed for patient with old age, moderate to severe atrophic gastritis and elevated morphology of lesions to prevent delayed diagnosis of synchronous gastric epithelial neoplasia.