Skip to main content

Advertisement

SpringerLink
Log in

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

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

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

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249

    Article  PubMed  Google Scholar 

  2. Xia C, Dong X, Li H et al (2022) Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J 135(05):584–590

    Article  PubMed  PubMed Central  Google Scholar 

  3. Yang L, Ying X, Liu S et al (2020) Gastric cancer: epidemiology, risk factors and prevention strategies. Chin J Cancer Res 32(6):695

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Machlowska J, Maciejewski R, Sitarz R (2018) The pattern of signatures in gastric cancer prognosis. Int J Mol Sci 19(6):1658

    Article  PubMed  PubMed Central  Google Scholar 

  5. Allemani C, Matsuda T, Di Carlo V et al (2018) Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. The Lancet 391(10125):1023–1075

    Article  Google Scholar 

  6. Hasuike N, Ono H, Boku N et al (2018) Gastrointestinal Endoscopy Group of Japan Clinical Oncology Group (JCOG-GIESG). A non-randomized confirmatory trial of an expanded indication for endoscopic submucosal dissection for intestinal-type gastric cancer (cT1a): the Japan Clinical Oncology Group study (JCOG0607). Gastric Cancer 21(1):114–123

    Article  PubMed  Google Scholar 

  7. Zhang X, Li M, Chen S et al (2018) Endoscopic screening in Asian countries is associated with reduced gastric cancer mortality: a meta-analysis and systematic review. Gastroenterology 155(2):347–354

    Article  PubMed  Google Scholar 

  8. Charvat H, Sasazuki S, Inoue M et al (2016) Prediction of the 10-year probability of gastric cancer occurrence in the Japanese population: the JPHC study cohort II. Int J Cancer 138(2):320–331

    Article  CAS  PubMed  Google Scholar 

  9. Hamashima C, Systematic Review Group and Guideline Development Group for Gastric Cancer Screening Guidelines (2018) Update version of the Japanese guidelines for gastric cancer screening. Jpn J Clin Oncol 48(7):673–683

    Article  PubMed  Google Scholar 

  10. Noh CK, Lee E, Lee GH et al (2021) Association of regular endoscopic screening with interval gastric cancer incidence in the National Cancer Screening Program. J Clin Med 11(1):230

    Article  PubMed  PubMed Central  Google Scholar 

  11. Chen R, Liu Y, Song G et al (2021) Effectiveness of one-time endoscopic screening programme in prevention of upper gastrointestinal cancer in China: a multicentre population-based cohort study. Gut 70(2):251–260

    PubMed  Google Scholar 

  12. Japanese Gastric Cancer Association (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 14(2):101–112

    Article  Google Scholar 

  13. Ono H, Yao K, Fujishiro M et al (2015) Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer. Dig Endosc 28(1):3–15

    Article  PubMed  Google Scholar 

  14. Ono H, Yao K, Fujishiro M et al (2021) Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer. Dig Endosc 33(1):4–20

    Article  PubMed  Google Scholar 

  15. Sugano K, Moss SF, Kuipers EJ (2023) Gastric intestinal metaplasia: real culprit or innocent bystander as a precancerous condition for gastric cancer? Gastroenterology 165(6):1352–1366.e1

    Article  PubMed  Google Scholar 

  16. Griniatsos J, Trafalis D (2018) Differences in gastric cancer surgery outcome between East and West: differences in surgery or different diseases? J BUON 23(5):1210–1215

    PubMed  Google Scholar 

  17. Assumpção PP, Barra WF, Ishak G et al (2020) The diffuse-type gastric cancer epidemiology enigma. BMC Gastroenterol 20(1):223

    Article  PubMed  PubMed Central  Google Scholar 

  18. Nam JH, Choi IJ, Cho SJ et al (2012) Association of the interval between endoscopies with gastric cancer stage at diagnosis in a region of high prevalence. Cancer 118(20):4953–4960

    Article  PubMed  Google Scholar 

  19. Whiting JL, Sigurdsson A, Rowlands DC et al (2002) The long term results of endoscopic surveillance of premalignant gastric lesions. Gut 50(3):378–381

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Morii Y, Arita T, Shimoda K et al (2001) Effect of periodic endoscopy for gastric cancer on early detection and improvement of survival. Gastric Cancer 4:132–136

    Article  Google Scholar 

  21. Jin S, Jeon SW, Kwon Y et al (2018) Optimal endoscopic screening interval for early detection of gastric cancer: a single-center study. J Korean Med Sci 33(23):e166

    Article  PubMed  PubMed Central  Google Scholar 

  22. Pimentel-Nunes P, Libânio D, Marcos-Pinto R et al (2019) Management of epithelial precancerous conditions and lesions in the stomach (maps II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019. Endoscopy 51(04):365–388

    Article  PubMed  Google Scholar 

  23. Banks M, Graham D, Jansen M et al (2019) British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma. Gut 68(9):1545–1575

    Article  PubMed  Google Scholar 

  24. Shah SC, Piazuelo MB, Kuipers EJ et al (2021) AGA clinical practice update on the diagnosis and management of atrophic gastritis: expert review. Gastroenterology 161(4):1325–1332

    Article  CAS  PubMed  Google Scholar 

  25. National Clinical Research Center for Digestive Disease (Shanghai), National Early Gastrointestinal-Center Prevention & Treatment Center Alliance, Helicobacter Pylori Group and Chinese Society of Gastroenterology et al (2020) Chinese consensus on management of gastric epithelial Chinese consensus on management of gastric epithelial precancerous conditions and lesions (2020). Chin J Dig 40(11):731–741

    Google Scholar 

  26. Sun L, Jin X, Huang L et al (2022) Risk of progression in patients with chronic atrophic gastritis: a retrospective study. Front Oncol 12:942091

    Article  PubMed  PubMed Central  Google Scholar 

  27. Menon S, Trudgill N (2014) How commonly is upper gastrointestinal cancer missed at endoscopy? A meta-analysis. Endosc Int Open 2(2):E46–E50

    Article  PubMed  PubMed Central  Google Scholar 

  28. Teh JL, Tan JR, Lau LJF et al (2015) Longer examination time improves detection of gastric cancer during diagnostic upper gastrointestinal endoscopy. Clin Gastroenterol Hepatol 13(3):480–487

    Article  PubMed  Google Scholar 

  29. Mommersteeg MC, Nieuwenburg SAV, den Hollander WJ et al (2021) Accuracy of upper endoscopies with random biopsies to identify patients with gastric premalignant lesions who can safely be exempt from surveillance. Gastric Cancer 24:680–690

    Article  PubMed  PubMed Central  Google Scholar 

  30. Liu Q, Ding L, Qiu X et al (2020) Updated evaluation of endoscopic submucosal dissection versus surgery for early gastric cancer: a systematic review and meta-analysis. Int J Surg 73:28–41

    Article  PubMed  Google Scholar 

  31. Choi MK, Kim GH, Park DY et al (2013) Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a single-center experience. Surg Endosc 27:4250–4258

    Article  PubMed  Google Scholar 

  32. Abe S, Takizawa K, Oda I et al (2021) Incidence and treatment outcomes of metachronous gastric cancer occurring after curative endoscopic submucosal dissection of undifferentiated-type early gastric cancer: Japan Clinical Oncology Group study—post hoc analysis of JCOG1009/1010. Gastric Cancer 24:1123–1130

    Article  PubMed  Google Scholar 

  33. Na YS, Kim SG, Cho SJ (2023) Risk assessment of metachronous gastric cancer development using OLGA and OLGIM systems after endoscopic submucosal dissection for early gastric cancer: a long-term follow-up study. Gastric Cancer 26(2):298–306

    Article  PubMed  Google Scholar 

Download references

Funding

This study was funded by “Pioneer” and “Leading Goose” R&D Program of Zhejiang (2023C03050) and Collaboration Program of Chinese Traditional and Modern Medicine in Gastric Cancer.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University, Youdian Street 54, Hangzhou, 310006, China

    Lu Sun, Yanjie Shen, Jing Zhao, Meng Li, Yue Hu & Bin Lyu

  2. Department of Endoscopy Center, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310006, China

    Liang Huang

  3. Key Laboratory of Digestive Pathophysiology of Zhejiang Province, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China

    Bin Lyu

Authors
  1. Lu Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yanjie Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Liang Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jing Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Meng Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yue Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bin Lyu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bin Lyu.

Ethics declarations

Disclosures

Bin Lyu has been funded by “Pioneer” and “Leading Goose” R&D Program of Zhejiang (2023C03050) and Collaboration Program of Chinese Traditional and Modern Medicine in Gastric Cancer. Lu Sun, Yanjie Shen, Liang Huang, Jing Zhao, Meng Li, and Yue Hu have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sun, L., Shen, Y., Huang, L. et al. Impact of endoscopic surveillance on the early diagnosis and endoscopic resection likelihood of gastric cancer. Surg Endosc 38, 2188–2196 (2024). https://doi.org/10.1007/s00464-024-10748-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-024-10748-4

Keywords

Search

Navigation