Therapeutic Decision-Making Using Endoscopic Ultrasonography in Endoscopic Treatment of Early Gastric Cancer

Soo-Jeong Cho; Jong Yeul Lee; Myeong-Cherl Kook; Chan Gyoo Kim; Keun Won Ryu; Young-Woo Kim; Il Ju Choi

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자료유형: 학술저널

저자정보: Soo-Jeong Cho Jong Yeul Lee Myeong-Cherl Kook Chan Gyoo Kim Keun Won Ryu Young-Woo Kim Il Ju Choi

저널정보: 거트앤리버 발행위원회 Gut and Liver Gut and Liver 제10권 제1호

발행연도: 2016.1

수록면: 42 - 50 (9page)

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Background/Aims: We evaluated the effectiveness of an endoscopic ultrasonography (EUS)-based treatment plan compared to an endoscopy-based treatment plan in selecting candidates with early gastric cancer (EGC) for endoscopic submucosal dissection based on the prediction of invasion depth. Methods: We reviewed 393 EGCs with differentiated histology from 380 patients who underwent EUS from July 2007 to April 2010. The effectiveness of the EUS-based and endoscopy-based plans was evaluated using a simplified hypothetical treatment algorithm. Results: The numbers of endoscopically determined mucosal, indeterminate, and submucosal cancers were 253 (64.4%), 56 (14.2%), and 84 (21.4%), respectively. Overall, the appropriate treatment selection rates were 75.3% (296/393) in the endoscopy-based plan and 71.5% (281/393) in the EUS-based plan (p=0.184). For endoscopic mucosal cancers, the appropriate treatment selection rates in the endoscopy-based plan were 88.1% (223/253), while the use of an EUS-based plan significantly decreased this rate to 81.4% (206/253) (p=0.036). For endoscopic submucosal cancers, the appropriate selection rates did not differ between the endoscopy-based plan (46.4%, 39/84) and the EUS-based plan (53.6%, 45/84) (p=0.070). Conclusions: EUS did not increase the likelihood of selecting the appropriate treatment in differentiated-type EGC. Therefore, EUS may not be necessary before treating differentiated-type EGC, especially in endoscopically presumed mucosal cancers.

#Early gastric cancer #Conventional endoscopy #Endosonography #Endoscopic submucosal dissection

참고문헌 (30)

참고문헌 신청

Isomoto H / 2009 / Endoscopic submucosal dissection for early gastric cancer: a large-scale feasibility study / Gut 58:331~336

Chung IK / 2009 / Therapeutic outcomes in 1000cases of endoscopic submucosal dissection for early gastric neoplasms:Korean ESD Study Group multicenter study / Gastrointest Endosc 69:1228~1235

Sano T / 1990 / Early gastric cancer: endoscopic diagnosis of depth of invasion / Dig Dis Sci 35:1340~1344

Choi J / 2011 / Endoscopic prediction of tumor invasion depth in early gastric cancer / Gastrointest Endosc 73:917~927

Hizawa K / 2002 / Is endoscopic ultrasonography indispensable in assessing the appropriateness of endoscopic resection for gastric cancer? / Endoscopy 34:973~978

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