Factors Affecting Endoscopic Curative Resection of Gastric Cancer in the Population-based Screening Era
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Background/Aims: Since population-based screening for gastric cancer in Korea was implemented, endoscopic treatment of early gastriccancer has become increasingly popular. This study investigates factors affecting endoscopic curative resection of early gastric cancerin population-based screening for gastric cancer. Methods: We retrospectively reviewed data of patients with newly diagnosed gastric cancer who underwent treatment at Seoul St. Mary’s Hospital. All patients completed questionnaires about clinical information, including interval between surveillance tests for gastriccancer. Results: Of 469 gastric cancer patients, 147 (31.3%) had undergone curative endoscopic resection, 260 (55.4%) had undergone curativesurgical resection, and 62 (13.3%) underwent non-curative resection or were in an inoperable state. Patients with curative endoscopic resectionhad fewer alarm symptoms/signs than other groups. In multivariate analysis, regular surveillance endoscopy was the only factorpredicting curative endoscopic resection (odds ratio [OR], 6.099; 95% confidence interval [CI], 2.532–14.933). In addition, patients undergoinggastric cancer screening had a significantly higher rate of endoscopic curative resection compared with subjects who had neverbeen screened. (1-year interval: OR, 49.969; 95% CI, 6.340–393.827, 2-year interval: OR, 15.283; 95% CI, 1.833–127.406, over 2-year interval:OR, 10.651; 95% CI, 1.248–90.871). Shorter screening test intervals were associated with higher rates of endoscopic curative resection. Conclusions: Regular surveillance testing was the independent factor predicting curative endoscopic resection of gastric cancer.
Abstract
Background/Aims: Since population-based screening for gastric cancer in Korea was implemented, endoscopic treatment of early gastriccancer has become increasingly popular. This study investigates factors affecting endoscopic curative resection of early gastric cancerin population-based screening for gastric cancer. Methods: We retrospectively reviewed data of patients with newly diagnosed gastric cancer who underwent treatment at Seoul St. Mary’s Hospital. All patients completed questionnaires about clinical information, including interval between surveillance tests for gastriccancer. Results: Of 469 gastric cancer patients, 147 (31.3%) had undergone curative endoscopic resection, 260 (55.4%) had undergone curativesurgical resection, and 62 (13.3%) underwent non-curative resection or were in an inoperable state. Patients with curative endoscopic resectionhad fewer alarm symptoms/signs than other groups. In multivariate analysis, regular surveillance endoscopy was the only factorpredicting curative endoscopic resection (odds ratio [OR], 6.099; 95% confidence interval [CI], 2.532–14.933). In addition, patients undergoinggastric cancer screening had a significantly higher rate of endoscopic curative resection compared with subjects who had neverbeen screened. (1-year interval: OR, 49.969; 95% CI, 6.340–393.827, 2-year interval: OR, 15.283; 95% CI, 1.833–127.406, over 2-year interval:OR, 10.651; 95% CI, 1.248–90.871). Shorter screening test intervals were associated with higher rates of endoscopic curative resection. Conclusions: Regular surveillance testing was the independent factor predicting curative endoscopic resection of gastric cancer.
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