Compliance with surveillance recommendations for foregut subepithelial tumors is poor: results of a prospective multicenter study

Kushnir, Vladimir; Keswani, Rajesh N.; Hollander, Thomas; Kohlmeier, Cara; Mullady, Daniel; Azar, Riad R.; Murad, Faris; Komanduri, Srinadh; Edmundowicz, Steven A.; Early, Dayna S.

doi:10.1016/j.gie.2014.11.013

Cited by 30 publications

(24 citation statements)

References 22 publications

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“…Supporting this recommendation, Song et al recently found no risk of progression for most incidental small SETs in the upper gastrointestinal tract in a large retrospective study 19. On the other hand, surveillance strategies often require life-long follow-up adherence by patients, which has been reported to be very poor 20 and always carries the risk of delayed diagnosis of malignancy. Notably, even for small SETs, rapid growth and early metastasis to the liver have been described 21.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided tissue sampling of small subepithelial tumors of the upper gastrointestinal tract with a 22-gauge core biopsy needle

Schlag

Menzel

Götzberger³

et al. 2017

Endosc Int Open

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Background and study aims The optimal approach to small subepithelial tumors (SETs) of the upper gastrointestinal tract remains inconclusive. The aim of this study was to evaluate endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for less invasive tissue sampling of small SETs of the upper gastrointestinal tract. Patients and methods In this prospective observational study patients with small ( ≤ 3 cm) SETs of the upper gastrointestinal tract were eligible and underwent EUS-FNB with a 22-gauge core biopsy needle. The main outcome measure was the diagnostic yield. The number of obtained core biopsies was also assessed. Results Twenty patients were included. The mean SET size was 16 mm (range 10 – 27 mm). EUS-FNB was technically feasible in all cases and no complications were observed. The diagnostic yield was 75 %. Core biopsy specimens were obtained in only 25 % of cases. Conclusion EUS-FNB with a 22-gauge core biopsy needle of small SETs can achieve a definite diagnosis in the majority of cases. However, because core samples cannot regularly be obtained, EUS-FNB seems not to be convincingly superior to standard EUS-FNA in this setting

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Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided tissue sampling of small subepithelial tumors of the upper gastrointestinal tract with a 22-gauge core biopsy needle

Schlag

Menzel

Götzberger³

et al. 2017

Endosc Int Open

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“…Patients with gastric SLS show poor compliance with surveillance recommendations, around 45%, 30 which highlights the importance of our results. Moreover, EUS practitioners present a significant ambiguity regarding criteria for malignancy and management of such tumors, 31,32 and EUS biopsies are not totally accurate for SLS.…”

Section: Discussionmentioning

confidence: 75%

“…Our study shows that the global management of SLS has been modified by ER in 29/33 cases (87.9%), which allowed stopping a costly follow‐up for benign lesions in 23/33 (69.7%), permitted a definitive oncological treatment in 10/33 (30.3%), and discovered and treated a misdiagnosed malignant cancer (well‐differentiated focal signet ring cells carcinoma) in one of 33 (3.0%). Patients with gastric SLS show poor compliance with surveillance recommendations, around 45%, 30 which highlights the importance of our results. Moreover, EUS practitioners present a significant ambiguity regarding criteria for malignancy and management of such tumors, 31 , 32 and EUS biopsies are not totally accurate for SLS.…”

Section: Discussionmentioning

confidence: 75%

Efficiency and safety of endoscopic resection in the management of subepithelial lesions of the stomach

et al. 2016

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Background: Gastric subepithelial tumors represent a diagnostic and therapeutic challenge, given their histologic heterogeneity and potential malignant behavior. Objective: The objective of this article is to evaluate the interest, efficiency and safety of endoscopic resection for subepithelial gastric lesions of size <20 mm. Methods: We conducted a single-center retrospective study in a tertiary care center. Results: A total of 33 lesions (10 malignant/23 benign lesions) were studied. Mean histological size was 14.5 mm. Nine EMR, 18 ESD and six hybrid resections were performed. A total of 93.9% lesions were resected in one piece. At six months' follow-up, complete and definitive resection was obtained in 96.7% of cases. A vertical resection was insufficient in four cases. One GIST needed a complementary surgical resection, one neuroendocrine tumor was successfully treated by a new ESD session and two pancreatic rests were not additionally treated given the benign character and the absence of residual tissue in endoscopic control after six months. There was only one severe adverse event (2.9%); one pneumoperitoneum with ESD, three bleeding with one ESD and two EMR, always treated conservatively or endoscopically. Conclusion: Endoscopic resection is safe and should be the procedure of choice for both diagnosis and definitive resection of subepithelial gastric lesions of size under 20 mm.

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“…An epidemiological study showed that compliance with periodic surveillance is poor, with fewer than 50 % of patients with SMTs undergoing periodic surveillance EUS as recommended. Therefore, most of the patients with poor compliance may lose the opportunity to undergo minimally invasive treatment [2]. As a result, most patients choose to undergo endoscopic resection of tumors originating from the muscularis propria (MP) layer rather than invasive open surgery.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and complications of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors and exploration for influencing factors

et al. 2018

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Compliance with surveillance recommendations for foregut subepithelial tumors is poor: results of a prospective multicenter study

Cited by 30 publications

References 22 publications

Endoscopic ultrasound-guided tissue sampling of small subepithelial tumors of the upper gastrointestinal tract with a 22-gauge core biopsy needle

Endoscopic ultrasound-guided tissue sampling of small subepithelial tumors of the upper gastrointestinal tract with a 22-gauge core biopsy needle

Efficiency and safety of endoscopic resection in the management of subepithelial lesions of the stomach

Efficacy and complications of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors and exploration for influencing factors

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