Endoscopic ultrasonography is valuable for identifying early gastric cancers meeting expanded-indication criteria for endoscopic submucosal dissection View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-08-24

AUTHORS

Kazuhisa Okada, Junko Fujisaki, Akiyoshi Kasuga, Masami Omae, Kazuhito Yoshimoto, Toshiaki Hirasawa, Akiyoshi Ishiyama, Yorimasa Yamamoto, Tomohiro Tsuchida, Etsuo Hoshino, Masahiro Igarashi, Hiroshi Takahashi

ABSTRACT

BackgroundEndoscopic ultrasonography (EUS) has become a reliable method for predicting the invasion depth of early gastric cancer (EGC). This study evaluated the accuracy of EUS in identifying lesions meeting expanded-indication criteria for endoscopic submucosal dissection (ESD) and analyzed clinicopathologic factors influencing the diagnostic accuracy of EUS in assessing tumor invasion depth.MethodsThis study investigated 542 EGCs of 515 patients who underwent EUS pretreatment. The pretreatment EUS-determined diagnosis was compared with the final histopathologic evaluation of resected specimens, and the impact of various clinicopathologic parameters on diagnostic accuracy was analyzed.ResultsThe diagnostic accuracy of EUS in identifying lesions meeting expanded-indication criteria for ESD was 87.8% (259/295) for differentiated adenocarcinoma (D-type) 30 mm in diameter or smaller, 43.5% (10/23) for D-type tumor larger than 30 mm in diameter, and 75% (42/56) for undifferentiated adenocarcinoma (UD-type) 20 mm in diameter or smaller. Using multivariate analysis, the diagnostic accuracy of EUS in predicting tumor invasion depth was determined to be decreased significantly by ulcerous change and large tumor size (diameter, ≥30 mm).ConclusionFor patients with EGC, D-type lesions 30 mm in diameter or smaller and UD-type lesions 20 mm in diameter or smaller can be diagnosed with high accuracy by EUS, but larger D-type lesions (diameter, >30 mm) should be considered carefully in terms of EUS-based treatment decisions. Findings of ulceration and large tumors are associated with incorrect diagnosis of tumor invasion depth by EUS. More... »

PAGES

841-848

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-010-1279-4

DOI

http://dx.doi.org/10.1007/s00464-010-1279-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1030575991

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/20734082


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36 schema:description BackgroundEndoscopic ultrasonography (EUS) has become a reliable method for predicting the invasion depth of early gastric cancer (EGC). This study evaluated the accuracy of EUS in identifying lesions meeting expanded-indication criteria for endoscopic submucosal dissection (ESD) and analyzed clinicopathologic factors influencing the diagnostic accuracy of EUS in assessing tumor invasion depth.MethodsThis study investigated 542 EGCs of 515 patients who underwent EUS pretreatment. The pretreatment EUS-determined diagnosis was compared with the final histopathologic evaluation of resected specimens, and the impact of various clinicopathologic parameters on diagnostic accuracy was analyzed.ResultsThe diagnostic accuracy of EUS in identifying lesions meeting expanded-indication criteria for ESD was 87.8% (259/295) for differentiated adenocarcinoma (D-type) 30 mm in diameter or smaller, 43.5% (10/23) for D-type tumor larger than 30 mm in diameter, and 75% (42/56) for undifferentiated adenocarcinoma (UD-type) 20 mm in diameter or smaller. Using multivariate analysis, the diagnostic accuracy of EUS in predicting tumor invasion depth was determined to be decreased significantly by ulcerous change and large tumor size (diameter, ≥30 mm).ConclusionFor patients with EGC, D-type lesions 30 mm in diameter or smaller and UD-type lesions 20 mm in diameter or smaller can be diagnosed with high accuracy by EUS, but larger D-type lesions (diameter, >30 mm) should be considered carefully in terms of EUS-based treatment decisions. Findings of ulceration and large tumors are associated with incorrect diagnosis of tumor invasion depth by EUS.
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44 EU
45 MethodsThis study
46 accuracy
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49 cancer
50 changes
51 clinicopathologic factors
52 clinicopathologic parameters
53 criteria
54 decisions
55 depth
56 diagnosis
57 diagnostic accuracy
58 diameter
59 dissection
60 early gastric cancer
61 endoscopic submucosal dissection
62 endoscopic ultrasonography
63 evaluation
64 factors
65 final histopathologic evaluation
66 finding of ulceration
67 findings
68 gastric cancer
69 high accuracy
70 histopathologic evaluation
71 impact
72 incorrect diagnosis
73 invasion depth
74 large tumors
75 larger tumor size
76 lesions
77 lesions 20
78 lesions 30
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82 patients
83 pretreatment
84 reliable method
85 resected specimens
86 size
87 specimens
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93 tumor size
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