Original articleClinical endoscopyWhen do we miss synchronous gastric neoplasms with endoscopy?
Section snippets
Materials and methods
Institutional review board approval was obtained before starting the study. This was a retrospective analysis of all patients who were diagnosed with synchronous multifocal gastric carcinomas after gastric resection surgery for cancer at Hanyang University Hospital between 2005 and 2008. All patients included in the sample underwent upper endoscopy before surgery. Preoperative upper endoscopy reports were drawn from the hospital's endoscopy database.
Cases were excluded if the endoscopist or
Baseline patient characteristics
Of 986 gastric cancer patients who underwent gastric resection at Hanyang University Hospital between January 2005 and September 2008, 51 (5.17%) cases of multifocal synchronous gastric cancer were diagnosed after surgical resection. During the study period, a total of 121 stomach cancer patients underwent an ESD or EMR procedure. Among 121 patients, 9 patients had multifocal lesions. Therefore, a total of 46 patients had multifocal lesions during the preoperative workup. Accordingly, 80.43% of
Discussion
In this study, we found that small lesion size was significantly correlated with the missed detection of accessory lesions. Even expert endoscopists can miss accessory lesions in as many as 27.5% of patients with synchronous multiple gastric carcinomas. Multiple synchronous gastric neoplasms were more frequently encountered in early gastric cancer.
Gastric cancer is the most common cause of cancer death in Korea.1, 2 Despite the improved prognosis of gastric cancer resulting from early
References (20)
- et al.
Multiple gastric cancers
Gastroenterology
(1957) Nationwide survey of the database system on gastric cancer patients
J Korean Gastric Cancer Assoc
(2004)- et al.
Gastric cancer surgery in cirrhotic patients: result of gastrectomy with D2 lymph node dissection
World J Gastroenterol
(2005) - et al.
Gastric cancer patients at high-risk of having synchronous cancer
World J Gastroenterol
(2006) - et al.
Study of clinicopathological factors associated with the occurrence of synchronous multiple gastric carcinomas
Gastric Cancer
(2009) - et al.
Extended lymph node dissection for gastric cancer: who may benefit?Final results of the randomized Dutch gastric cancer group trial
J Clin Oncol
(2004) - et al.
Recurrence following curative resection for gastric carcinoma
Br J Surg
(2000) - et al.
Clinicopathological analysis of synchronous multiple gastric carcinoma
Eur J Surg Oncol
(1989) - et al.
Synchronous multiple early gastric carcinomaA study of 178 cases
World J Surg
(1985) - et al.
Multiple gastric cancer from the pathological viewpoint [in Japanese with English abstract]
Stomach and Intestine
(1994)
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. This work was supported by the research fund of Hanyang University (HY-2009-N).