Size discrepancy between endoscopic size and pathologic size is not negligible in endoscopic resection for early gastric cancer
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- 作者：Choong Nam Shim (1)
Mi Kyung Song (2)
Dae Ryong Kang (2)
Hyun Soo Chung (1)
Jun Chul Park (1)
Hyuk Lee (1)
Sung Kwan Shin (1)
Sang Kil Lee (1)
Yong Chan Lee (1) - 关键词：Early gastric cancer ; Size ; Discrepancy ; Endoscopic resection
- 刊名：Surgical Endoscopy
- 出版年：2014
- 出版时间：July 2014
- 年：2014
- 卷：28
- 期：7
- 页码：2199-2207
- 全文大小：263 KB
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Mi Kyung Song (2)
Dae Ryong Kang (2)
Hyun Soo Chung (1)
Jun Chul Park (1)
Hyuk Lee (1)
Sung Kwan Shin (1)
Sang Kil Lee (1)
Yong Chan Lee (1)
1. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
2. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea - ISSN：1432-2218
文摘
Background Accurate tumor size measurement is critical for selecting proper candidates for endoscopic resection (ER) of early gastric cancer (EGC). However, size discrepancy between endoscopic size and pathologic size often occurs during ER for EGC. Objective The purposes of this study were to investigate the clinicopathological characteristics related to size discrepancy and the clinical implications of size discrepancies in terms of therapeutic outcomes. Methods Between April 2006 and June 2013, a total of 820 patients with 826 EGCs underwent ER. Enrolled lesions were categorized into the following three groups based on size discrepancy between endoscopic size and pathologic size: well-estimated (N?=?308), underestimated (N?=?215), or overestimated (N?=?303) lesions. The well-estimated group was defined as lesions with a ratio of endoscopic size to pathologic size from 0.7 to 1.3. Results The overall median size discrepancy was 5.0?mm (interquartile range 2.0-.0). Size, location, macroscopic type, primary tumor stage, and histology differed significantly between the three groups. Larger size [odds ratio (OR) 5.07, 95 % confidence interval (CI) 3.38-.59, p?p?=?0.008), and undifferentiated histology (OR 2.24, 95?%?CI 1.31-.83, p?=?0.003) were independent risk factors for endoscopic size underestimation in multivariate analysis. Smaller size (OR 10.95, 95?%?CI 4.64-5.87, p? Conclusions Larger size, flat/depressed type, and undifferentiated histology of EGC carry a significant risk for endoscopic underestimation of lesion size, which results in the lower rates of complete and curative resections for EGC. Further studies to reduce size discrepancy are warranted.