Endoscopy 2018; 50(04): S76-S77
DOI: 10.1055/s-0038-1637254
ESGE Days 2018 oral presentations
21.04.2018 – Stomach: Improving diagnosis
Georg Thieme Verlag KG Stuttgart · New York

PROXIMAL EGCS HAVE DIFFERENT CLINICAL AND PATHOLOGIC CHARACTERISTICS COMPARED WITH DISTAL EGCS

MK Joo
1   Korea University Guro Hospital, Gastroenterology, Seoul, Korea, Republic of
,
SH Park
2   The Catholic University, Division of Gastroenterology, Department of Internal Medicine, Seoul, Korea, Republic of
,
JS Koh
1   Korea University Guro Hospital, Gastroenterology, Seoul, Korea, Republic of
,
BJ Lee
1   Korea University Guro Hospital, Gastroenterology, Seoul, Korea, Republic of
,
JJ Park
1   Korea University Guro Hospital, Gastroenterology, Seoul, Korea, Republic of
,
HJ Chun
3   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
SW Lee
4   Korea University Ansan Hospital, Gastroenterology, Kyungki-do, Korea, Republic of
,
YT Bak
1   Korea University Guro Hospital, Gastroenterology, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Limited data have shown the different clinical and histopathologic characteristics of EGCs according to location. The purpose of this study was to evaluate the clinical and histopathologic features of the proximal EGCs by comparing those from distal EGCs.

Methods:

We retrospectively reviewed the medical records of patients with EGC treated by ESD or surgery at Korea University Guro Hospital between March 2007 and March 2016. All EGC patients were subdivided according to the location. Among the EGC patients, the proximal EGC group (EGCs located in cardia, high body and fundus) and the distal group (EGCs located in antrum) were set by 1:3 ratio matching by age and gender.

Results:

A total of 369 patients were enrolled, of which 92 (25%) were proximal EGC group and 277 (75%) were distal EGC group. Univariate analysis showed significantly that the proximal EGCs were more surgically treated (56.0% vs. 20.2%, p< 0.001), more undifferentiated type (38.0% vs. 19.9%, p= 0.001), larger size (29.5 ± 19.4 vs. 20.3 ± 16.8 mm, p< 0.001), and more SM invasion (60.9 vs. 25.9%, p< 0.001) than the distal EGC group respectively. In multivariate analysis, significant risk factors for SM invasion were location (upper body; odds ratio [OR] 3.62, p= 0.002), lymphovascular (LV) invasion (OR 5.98, p= 0.003), and size > 3.0 cm (OR 2.49, p= 0.002). When analyzing EGCs less than 3.0 cm separately (n = 280), multivariate analysis revealed that location (upper body; OR 6.67, p< 0.001) and LV invasion (OR 9.96, p= 0.005) were significant risk factors for SM invasion.

Conclusions:

Proximal EGCs significantly had undifferentiated type, larger size and SM cancer compared with distal EGCs. Multivariate analysis showed that the proximal location was a significant risk factor for SM invasion, which was consistent by subgroup analysis among EGCs < 3.0 cm. Therefore, clinicians need to be cautious when setting the therapeutic plan for proximal EGCs.