AI Article Synopsis
- Advances in endoscopic submucosal dissection (ESD) have led to more early gastric cancer (EGC) diagnoses, particularly in the gastric angulus area of the stomach among the Chinese population.
- A study of 740 EGC patients revealed that the gastric angulus is the second most common site for EGCs, with this location showing a high incidence of severe submucosal fibrosis and ulceration.
- There is a significant correlation between submucosal fibrosis at the gastric angulus and worse ESD outcomes, such as increased complications like perforation and longer procedure times, highlighting the need for careful dissection in these cases.
Article Abstract
Background: With advances in endoscopic submucosal dissection (ESD) technique, an increasing number of the Chinese population are being diagnosed with early gastric cancers (EGCs) at gastric angulus. However, the relationship between gastric angulus and EGCs remains obscure.
Objectives: We aimed to unveil the unreported location characteristics of gastric angulus in Chinese EGC patients and the correlation between the degree of submucosal fibrosis and ESD outcomes.
Methods: We retrospectively reviewed the medical records of EGC patients treated with ESD from January 2010 to March 2023. We retrospectively investigated and analyzed 740 EGC patients using multiple analyses.
Results: Following gastric antrum (53.1%), the gastric angulus (21.8%) emerged as the second-most prevalent site for EGCs. It had highest incidence of severe submucosal fibrosis and ulceration than the other parts. Multivariate analysis showed independent associations of submucosal fibrosis at the angulus with ulceration (OR: 3.714, 95% CI: 1.041-13.249), procedure duration (OR: 1.037, 95% CI: 1.014-1.061), and perforation complication (OR: 14.611, 95% CI: 1.626-131.277) (all P < 0.05).
Conclusions: The gastric angulus demonstrates the highest incidence of severe submucosal fibrosis and ulceration for EGCs identified by ESD. This condition is linked to unfavorable outcomes, typically increased perforation risks and prolonged operation duration. Therefore, meticulous dissection is crucial for patients with EGCs in the gastric angulus.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290107 | PMC |
| http://dx.doi.org/10.1186/s12885-024-12610-1 | DOI Listing |
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