ArticleDigestive diseases and sciences2019
Endoscopic Indication of Endoscopic Submucosal Dissection for Early Gastric Cancer Is Not Compatible with Pathologic Criteria in Clinical Practice.
Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Discrepancies between preoperative assessment and final pathological criteria in early gastric cancer.World journal of gastrointestinal oncology · 2026Article
- Overcoming diagnostic pitfalls in primary gastric squamous cell carcinoma: the imperative of adequate sampling in an elderly female patient, case report.Frontiers in oncology · 2025Article
- Need for careful endoscopic evaluation of large gastric neoplasms before endoscopic submucosal dissection.Clinical endoscopy · 2022Article
- [Clinical Value of White Light Image, Endoscopic Ultrasonography and Magnifying Endoscopy with Narrow Band Imaging in Evaluation of Indications for Endoscopic Treatment of Early Gastric Cancer].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2022Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe inappropriate selection of patients with early gastric cancer (EGC) for endoscopic submucosal dissection (ESD) may lead to additional surgery because of a non-curative resection. This study was performed to assess the accuracy of clinical decisions in ESD for EGC.
methodsA total of 607 cases of EGC treated by ESD were prospectively enrolled from January 2011 to June 2014 at a single academic hospital. The 607 EGCs were divided into three groups (overestimated, same-estimated, and underestimated) based on pre-procedure endoscopic findings (indication) and pathological diagnosis after ESD (criteria). We evaluated the discrepancy rates between pre-procedure indication and pathological criteria, and then analyzed the pre-procedure factors that could influence the occurrence of the discrepancies.
resultsThe absolute, expanded, and beyond the expanded indication has its accuracy on curability criteria in 87%, 77.6%, and 55.6% of cases, respectively. The ratio of overall indication-criteria discrepancies was 250/607 (41.2%). The curability was significantly lower in the underestimated group compared to the overestimated and same-estimated groups (41.6% vs. 94.6%, 94.4%, p < 0.001). In multivariate analysis examining the predictive factors for discrepancies in the 598 EGCs with absolute/expanded indications, the endoscopic size ≥ 20 mm [odds ratio (OR) 2.493, confidence interval (CI) 1.546-4.022, p < 0.001], presence of ulcers (OR 1.712, CI 1.070-2.738, p = 0.025), patient age < 60 years (OR 1.689, CI 1.044-2.733, p = 0.033), and undifferentiated type EGC on forceps biopsy (OR 5.397, CI 2.027-14.369, p = 0.001) were all associated with discrepancies.
conclusionsIndication judged by pre-procedural endoscopy is not sufficiently accurate to be used as a good measurement for post-procedural criteria.
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