Indefinite gastric lesions: when to intervene surgically

  • Kwon MJ & al.
  • World J Gastroenterol
  • 28 Jan 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 4 clinical risk factors can help identify patients with a lesion that is indefinite for neoplasm/dysplasia (IFND) who could benefit from endoscopic resection, rather than repeated endoscopic biopsy.
  • 2 or more clinical risk factors should be considered for resection, and diagnosis should be made within 1 year for patients without risk factors.

Why this matters

  • There is limited guidance for how to follow-up and monitor patients with IFND.

Study design

  • Retrospective analysis of 461 patients with IFND at a single institution in Korea whose diagnoses were confirmed by endoscopic resection (n=134), surgery (n=22), or follow-up endoscopic biopsy (n=305).
  • Funding: None disclosed.

Key results

  • Multivariate analysis revealed 6 factors associated with increased risk for gastric carcinoma:
    • Age ≥60 years (OR, 2.445; P=.005).
    • Endoscopic size ≥10 mm (OR, 3.519; P<.001>
    • Single lesion (OR, 5.702; P<.001>
    • Spontaneous bleeding (OR, 4.056; P=.001).
    • Atypical epithelium described as IFND (OR, 25.575; P<.001>
    • Repeated pathologic reports of IFND (OR, 6.022; P=.003).
  • 2 or more clinical risk factors: sensitivity of 91.3% and specificity of 54.9% for carcinoma.
  • There was no association between worse prognoses and diagnostic delays up to 1 year.

Limitations

  • Retrospective analysis.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit