ArticleWorld journal of gastrointestinal oncology2026
Discrepancies between preoperative assessment and final pathological criteria in early gastric cancer.
Article in World journal of gastrointestinal oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- AI Revolution in Upper GI: Endoscopic Diagnosis of Gastric Cancers and Premalignant Neoplasms.Diseases (Basel, Switzerland) · 2026Review
- Acute gastrointestinal hemorrhage as the sole initial manifestation of gastric leiomyosarcoma: a case report highlighting the discrepancy between preoperative assessment and final pathology.Frontiers in oncology · 2026Article
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4 authors.
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Abstract
backgroundInappropriate selection of patients with early gastric cancer (EGC) for endoscopic submucosal dissection (ESD) may lead to non-curative resection, necessitating additional gastrectomy. Conversely, inappropriate selection for gastrectomy may result in overtreatment, adversely affecting patients' quality of life. Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC. To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients', we specifically assess the suitability of Japanese guidelines in non-Japanese populations. This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.
aimTo evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.
methodsA retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022. Cases were categorized into three groups: Same-estimated (preoperative therapeutic indication with postoperative pathological criteria matched), underestimated (preoperative ESD indication but postoperative surgical criteria), and overestimated (preoperative surgical indication but postoperative ESD criteria). The rate of discrepancy and associated risk factors were assessed.
resultsThe accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0% (321/430) and 76.0% (278/366), respectively. The overall discrepancy rate was 25.6% (204/796). Multivariate analysis identified tumor location in the upper-third stomach (odds ratio = 2.158, 95% confidence interval: 1.373-3.390,
conclusionThe accuracy of preoperative EGC indications is 74.4%. Upper-third stomach and undifferentiated histology are primary discrepancy predictors. Upper-third tumors are prone to underestimation, while undifferentiated tumors are prone to overestimation.
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