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Surgical Endoscopy
Published in: Surgical Endoscopy 4/2024

06-03-2024 | Gastric Cancer

Impact of endoscopic surveillance on the early diagnosis and endoscopic resection likelihood of gastric cancer

Authors: Lu Sun, Yanjie Shen, Liang Huang, Jing Zhao, Meng Li, Yue Hu, Bin Lyu

Published in: Surgical Endoscopy | Issue 4/2024

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Abstract

Background

Endoscopy could help detect early gastric cancer (EGC) and improve the prognosis of patients. The aim of this study was to analyze the impact of endoscopy and endoscopic surveillance on the early detection of gastric cancer (GC), GC staging, and treatment selection.

Methods

Patients with GC diagnosed at our center from 2010 to 2022 were retrospectively analyzed and allocated to the short-interval group (had received endoscopy within 3 years before diagnosis), the long-interval group (had received endoscopy more than 3 years before diagnosis), and the unchecked group (had not received endoscopy before diagnosis). The differences in GC staging and treatment modalities among the three groups were analyzed, and the differences in the clinical and pathological features of EGC were further analyzed.

Results

One thousand and twenty-five GC patients were included, with 395 cases of EGC and 630 cases of advanced GC. The proportions of EGC in the short-interval, long-interval, and unchecked groups were 98.0%, 84.2%, and 29.8%, respectively (p < 0.001). Among the 387 lesions of 367 EGC patients were resected by endoscopic submucosal dissection (ESD), 341 (88.1%) exhibited curative resection, and 46 (11.9%) involved noncurative resections. Lesions of EGC differed significantly in diameter, depth of invasion, and curative resection rate (p = 0.033, 0.019, and 0.005, respectively). In the short-interval group, 87.8% of the lesions were ≤ 2 cm, 95.6% of the invasion depths were confined to the mucosal layer, and 96.7% of the eCura scores were A or B. Compared with the unchecked group, they had smaller diameters (RR = 0.419, 95% CI 0.234–0.752), shallower invasion depths (RR = 0.286, 95% CI 0.105–0.777), and a higher curative resection rate (RR = 0.215, 95% CI 0.068–0.676).

Conclusion

Endoscopic surveillance at 3-year intervals can help detect EGC, and the EGC lesions found have smaller diameters and shallower depths of invasion, helping improve the curative resection rate of ESD.

Graphical abstract

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Metadata
Title
Impact of endoscopic surveillance on the early diagnosis and endoscopic resection likelihood of gastric cancer
Authors
Lu Sun
Yanjie Shen
Liang Huang
Jing Zhao
Meng Li
Yue Hu
Bin Lyu
Publication date
06-03-2024
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 4/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-024-10748-4

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