* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project
The optimal endoscopic screening interval for detecting early gastric neoplasms CH Park, EH Kim, HS Chung, H Lee, JC Park, SK Shin, YC Lee, JY An, HI Kim, JH Cheong, WJ Hyung, SH Noh, CB Kim, SK Lee GASTROINTESTINAL ENDOSCOPY 2014;80:253-9. F1 손주웅 Introduction Gastric cancer • the major causes of cancer-related death worldwide • almost 990,000 cases are detected annually • The prognosis depends on the tumor stage The National Cancer Screening Program in Korea • biennial gastric cancer screening for adults aged 40 years and older United Kingdom–based study • Annual endoscopic surveillance in patients with • atrophic gastritis or intestinal metaplasia detect most new tumors sufficiently early to allow a major improvement in survival Introduction Many reports suggested that 2 to 3 years is an optimal screening interval • included a relatively small number of patients with gastric cancer • no patients with gastric adenoma The optimal interval between endoscopic examinations for detecting early gastric neoplasms, including gastric adenomas, has not previously been studied. Introduction It is important to include adenoma in these studies for several reasons • almost all adenomas that were resected by endoscopic • submucosal dissection (ESD) were diagnosed by endoscopic screening. endoscopic screening aims both to reduce gastric cancerrelated mortality and to detect gastric neoplasms that can be treated in a way that better preserves organs, compared with surgery. This study aimed • to evaluate the optimal interval between endoscopic examinations for the early diagnosis of both gastric cancers and adenomas. METHODS Patients • diagnosed with gastric neoplasms including gastric • adenoma and gastric cancer in Severance Hospital, between January 2008 and August 2013. a questionnaire survey by interview at outpatient clinics or by a telephone poll. METHODS METHODS Treatment method • EGCs that appeared to meet the indication for ESD were treated with ESD • differentiated intramucosal adenocarcinoma <3 cm in diameter • • • without lymphovascular invasion, irrespective of ulcer findings differentiated intramucosal adenocarcinoma without lymphovascular invasion and negative for ulceration, irrespective of tumor size undifferentiated intramucosal cancer <2 cm without lymphovascular invasion and ulcer findings differentiated adenocarcinomas <3 cm with minimal submucosal invasion (<500 ㎛) and without lymphovascular invasion • Patients who were diagnosed with adenoma underwent ESD. METHODS Gross and histopathologic evaluation • Tumor location • endoscopically evaluated • classified by the Japanese Gastric Cancer Association Classification criteria • Tumor size, invasion depth, the presence of an ulcer, lymphatic and vascular involvement, and lymph node metastasis • histopathologically assessed • Pathologic stages • the 7th edition of the American Joint Committee on Cancer/ Union Internationale Contre le Cancer tumornode-metastasis staging system RESULTS Clinicopathologic characteristics 66% 50.7% 31.1% RESULTS Optimal interval between endoscopic examinations RESULTS Effect of endoscopy screening interval on possibility of ESD and lesion stage Conclusion Annual endoscopy cannot facilitate the detection of endoscopically treatable gastric neoplasms compared with biennial or triennial endoscopy. This study recommend biennial endoscopic screening for gastric neoplasms • increase the proportion of lesions discovered while • they are still endoscopically treatable to reduce the number of lesions that progress to advanced gastric cancer.