Endoscopic features suggesting gastric cancer in biopsy-proven gastric adenoma with high-grade neoplasia

Kim, Jung Ho

doi:10.3748/wjg.v20.i34.12233

Cited by 13 publications

(14 citation statements)

References 30 publications

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“…Curative R0 resection and D2 lymph node dissection according to the Japanese Gastric Cancer Association were performed when possible. As previously reported, endoscopic submucosal dissection was performed accordance to standard methods ( 11 12 ). All of the patients underwent computed tomography with/without endoscopic ultrasonography before treatment.…”

Section: Methodsmentioning

confidence: 99%

Clinicopathologic Similarities of the Main and Minor Lesions of Synchronous Multiple Early Gastric Cancer

et al. 2016

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The detection rate of early gastric cancer (EGC) is increasing due to improvements in diagnostic methods, but synchronous multiple EGC (SMEGC) remains a major problem. Therefore, we investigated the characteristics of and the correlation between the main and minor lesions of SMEGC. We retrospectively reviewed the medical records of patients with EGC between April 2008 and May 2013. The main lesion was defined as the one with the greatest invasion depth. If lesions had the same invasion depth, the tumor diameter was used to define the main lesion. Of 963 patients who had treatment for EGC, 37 patients with SMEGC were analyzed. The main and minor lesions showed a significant positive correlation of size (r = 0.533, P = 0.001). The main and minor lesions of SMEGC showed the same vertical and horizontal locations at 70.3% and 64.9%, respectively (P = 0.002 and P = 0.002). Macroscopic types were identical in 67.6% (P < 0.001), and 32.4% had identical macroscopic type and location. The main and minor lesions had identical characteristics of invasion depth, presence of lymphovascular invasion (LVI), and differentiation in 78.4%, 83.8%, and 83.8%, respectively. Differentiation, LVI, and invasion depth (microscopic characteristics) were simultaneously the same in 62.2%. The location, macroscopic type, and 3 microscopic characteristics were matched in 27%. The main and minor lesions of SMEGC have similar clinicopathologic characteristics. Therefore, the possibility of SMEGC should not be neglected in cases of EGC, considering an understanding of the characteristics and association of lesions.

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Section: Methodsmentioning

confidence: 99%

Clinicopathologic Similarities of the Main and Minor Lesions of Synchronous Multiple Early Gastric Cancer

et al. 2016

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“…The surface appearance of dysplasia has also been identified as a risk factor for upgrade to a diagnosis of HGD or carcinoma in gastric LGD after endoscopic resection. Features associated with an upgraded diagnosis include depressed macroscopic type, surface erythema, surface unevenness (nodularity), and erosion or ulceration [ 31 , 32 , 34 - 39 ]. The risk of malignancy is also related to the villosity of the growth pattern [ 33 ].…”

Section: Histologic Discrepancy: Forceps Biopsy and Endoscopic Resectmentioning

confidence: 99%

Diagnosis and management of gastric dysplasia

Sung

2016

Korean J Intern Med

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Gastric dysplasia is a neoplastic lesion and a precursor of gastric cancer. The Padova, Vienna, and World Health Organization classifications were developed to overcome the discrepancies between Western and Japanese pathologic diagnoses and to provide a universally accepted classification of gastric epithelial neoplasia. At present, the natural history of gastric dysplasia is unclear. Much evidence suggests that patients with high-grade dysplasia are at high risk of progression to carcinoma or synchronous carcinoma. Therefore, endoscopic resection is required. Although patients with low-grade dysplasia have been reported to be at low risk of progression to carcinoma, due to the marked histologic discrepancies between forceps biopsy and endoscopic specimens, endoscopic resection for this lesion is recommended, particularly in the presence of other risk factors (large size; depressed gross type; surface erythema, unevenness, ulcer, or erosion; and tubulovillous or villous histology). Helicobacter pylori eradication in patients with dysplasia after endoscopic resection appear to reduce the incidence of metachronous lesions.

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“…Similar to prior reports on gastric neoplasia, our study demonstrated that histologic discordance between forceps biopsy and ESD is not uncommon. Factors associated with downgrade compared to upgrade histology have included smaller tumor size and a lower number of biopsy specimens, further highlighting the limitations of establishing a diagnosis with forceps biopsies 28 29 . Hence, when pretreatment diagnosis is uncertain or fails to identify advanced disease, ESD may prove to be an accurate staging procedure to guide subsequent management.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of endoscopic submucosal dissection for rectal neoplasia: a multicenter North American experience

et al. 2019

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ABSTR AC TBackground and aims Rectal lesions traditionally represent the first lesions approached during endoscopic submucosal dissection (ESD) training in the West. We evaluated the safety and efficacy of rectal ESD in North America.Methods This is a multicenter retrospective analysis of rectal ESD between January 2010 and September 2018 in 15 centers. End points included: rates of en bloc resection, R0 resection, adverse events, comparison of pre-and post-ESD histology, and factors associated with failed resection. ResultsIn total, 171 patients (median age 63 years; 56 % men) underwent rectal ESD (median size 43 mm). En bloc resection was achieved in 141 cases (82.5 %; 95 %CI 76.8-88.2), including 24 of 27 (88.9 %) with prior failed endoscopic mucosal resection (EMR). R0 resection rate was 74.9 % (95 %CI 68.4-81.4). Post-ESD bleeding and perforation occurred in 4 (2.3 %) and 7 (4.1 %), respectively. Covert submucosal invasive cancer (SMIC) was identified in 8.6 % of post-ESD specimens. There was one case (1/120; 0.8 %) of recurrence at a median follow-up of 31 weeks; IQR: 19-76 weeks). Older age and higher body mass index (BMI) were predictors of failed R0 resection, whereas submucosal fi-R0 resection, n (%) 128 (74.9 %) R1 resection, n (%) 20 (11.7 %) Rx resection, n (%) 23 (13.5 %) Overall curative resection, n (%) 125 (73.1 %) Curative resection for superficial invasive adenocarcinoma (n = 11) , n (%) 9 (81.8 %) Adverse events, n (%) ▪ Bleeding 4 (2.3 %) ▪ Perforation 7 (4.1 %) ▪ Nausea/abdominal pain 3 (2.9 %) ▪ Postoperative urinary retention 3 (1.8 %)▪ Post-ESD anal stricture 1 (0.6 %) EMR, endoscopic mucosal resection; ESD, endoscopic submucosal dissection.

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Endoscopic features suggesting gastric cancer in biopsy-proven gastric adenoma with high-grade neoplasia

Abstract: HGN with a red color change or mucosal ulceration correlated with the presence of gastric cancer. These finding may help to guide the diagnosis and treatment.

Cited by 13 publications

References 30 publications

Clinicopathologic Similarities of the Main and Minor Lesions of Synchronous Multiple Early Gastric Cancer

Clinicopathologic Similarities of the Main and Minor Lesions of Synchronous Multiple Early Gastric Cancer

Diagnosis and management of gastric dysplasia

Safety and efficacy of endoscopic submucosal dissection for rectal neoplasia: a multicenter North American experience

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