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Impact of Periodic Endoscopy on Incidentally Diagnosed Gastric Gastrointestinal Stromal Tumors: Findings in Surgically Resected and Confirmed Lesions

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although gastric gastrointestinal stromal tumors (GISTs) are usually identified by endoscopic examinations, the diagnostic value of endoscopy has not been fully evaluated. We assessed the diagnostic performance of endoscopy for gastric GISTs according to lesion characteristics. Furthermore, the benefits of periodic endoscopy prior to diagnosis of gastric GISTs were evaluated.

Methods

We reviewed patients who underwent surgery for gastric GISTs at Severance Hospital, Seoul, Korea, between January 2008 and April 2014. In addition, we administered a questionnaire to determine the usage of periodic endoscopic inspection and the period from the penultimate endoscopy to the diagnosis.

Results

Of 174 included patients, 109 (62.4 %) showed intraluminally growing GISTs and 65 (37.4 %) showed extraluminally growing GISTs. The proportions of lesions that were initially diagnosed via endoscopy were 99.1 % for intraluminally growing GISTs and 49.2 % for extraluminally growing GISTs (P < 0.001). In patients with intraluminally growing GISTs, patients who had undergone endoscopy within 3 years prior to the diagnosis showed smaller tumor sizes (P = 0.015) and fewer tumors with ulceration (7.1 vs. 28.4 %, P = 0.021). The proportion of GISTs with a high mitotic index did not differ according to the usage of periodic endoscopy (P = 0.639). In contrast, lesion characteristics of the extraluminally growing GISTs did not differ according to whether an endoscopy was performed within 3 years prior to the diagnosis.

Conclusions

Endoscopic examinations had a limited role in the diagnosis of extraluminally growing GISTs. However, periodic endoscopy was associated with relatively earlier detection of growth in intraluminal gastric GISTs.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea

    Chan Hyuk Park MD, Eun Hye Kim MD, Da Hyun Jung MD, Hyunsoo Chung MD, Jun Chul Park MD, Sung Kwan Shin MD, Yong Chan Lee MD, PhD & Sang Kil Lee MD, PhD

  2. Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hoguen Kim MD, PhD

Authors
  1. Chan Hyuk Park MD
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  2. Eun Hye Kim MD
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  4. Hyunsoo Chung MD
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  7. Yong Chan Lee MD, PhD
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  9. Sang Kil Lee MD, PhD
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Correspondence to Sang Kil Lee MD, PhD.

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Park, C.H., Kim, E.H., Jung, D.H. et al. Impact of Periodic Endoscopy on Incidentally Diagnosed Gastric Gastrointestinal Stromal Tumors: Findings in Surgically Resected and Confirmed Lesions. Ann Surg Oncol 22, 2933–2939 (2015). https://doi.org/10.1245/s10434-015-4517-0

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  • DOI: https://doi.org/10.1245/s10434-015-4517-0

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