Cargando…
Necessity of Individualized Approach for Gastric Subepithelial Tumor Considering Pathologic Discrepancy and Surgical Difficulty Depending on the Gastric Location
Background: Depending on the location of gastric subepithelial tumors (SETs), surgical access is difficult with a risk of postoperative complications. This study aimed to evaluate the clinicopathological characteristics of small-sized gastric SETs and their surgical outcomes depending on location an...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409778/ https://www.ncbi.nlm.nih.gov/pubmed/36012971 http://dx.doi.org/10.3390/jcm11164733 |
_version_ | 1784774934234398720 |
---|---|
author | Kim, Sung Gon Eom, Bang Wool Yoon, Hongman Kook, Myeong-Cheorl Kim, Young-Woo Ryu, Keun Won |
author_facet | Kim, Sung Gon Eom, Bang Wool Yoon, Hongman Kook, Myeong-Cheorl Kim, Young-Woo Ryu, Keun Won |
author_sort | Kim, Sung Gon |
collection | PubMed |
description | Background: Depending on the location of gastric subepithelial tumors (SETs), surgical access is difficult with a risk of postoperative complications. This study aimed to evaluate the clinicopathological characteristics of small-sized gastric SETs and their surgical outcomes depending on location and provide considering factors for their treatment plans. Methods: This single-center, retrospective study reviewed patients who underwent surgical resection for gastric SETs (size < 5 cm). SETs were divided into benign SETs and gastrointestinal stromal tumors (GISTs) for comparison. The clinicopathological characteristics of SETs in the cardia were compared to those in the other regions. Results: Overall, 191 patients with gastric SETs (135 GISTs, 70.7%; and 56 benign SETs, 29.3%) were included. In multivariate analysis, age > 65 years (odds ratio (OR), 3.183; 95% confidence interval (CI), 1.310–7.735; p = 0.011), and non-cardiac SETs (OR, 2.472; 95% CI, 1.110–5.507; p = 0.030) were associated with a significant risk of malignancy. Compared to SETs in other locations, cardiac SETs showed more complications (3 versus 0; p = 0.000), and open conversion rates (2 versus 0; p = 0.003). However, the proportion of GISTs of SETs in the cardia is not negligible (52.9%). Conclusions: Considering the malignancy risk of SETs, active surgical resection should be considered in old age and/or location in the non-cardiac area. However, in young patients, SETs located in the gastric cardia have a considerably benign nature and are associated with poor short-term surgical outcomes. An individualized surgical approach for asymptomatic small SETs according to the gastric location is warranted. |
format | Online Article Text |
id | pubmed-9409778 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94097782022-08-26 Necessity of Individualized Approach for Gastric Subepithelial Tumor Considering Pathologic Discrepancy and Surgical Difficulty Depending on the Gastric Location Kim, Sung Gon Eom, Bang Wool Yoon, Hongman Kook, Myeong-Cheorl Kim, Young-Woo Ryu, Keun Won J Clin Med Article Background: Depending on the location of gastric subepithelial tumors (SETs), surgical access is difficult with a risk of postoperative complications. This study aimed to evaluate the clinicopathological characteristics of small-sized gastric SETs and their surgical outcomes depending on location and provide considering factors for their treatment plans. Methods: This single-center, retrospective study reviewed patients who underwent surgical resection for gastric SETs (size < 5 cm). SETs were divided into benign SETs and gastrointestinal stromal tumors (GISTs) for comparison. The clinicopathological characteristics of SETs in the cardia were compared to those in the other regions. Results: Overall, 191 patients with gastric SETs (135 GISTs, 70.7%; and 56 benign SETs, 29.3%) were included. In multivariate analysis, age > 65 years (odds ratio (OR), 3.183; 95% confidence interval (CI), 1.310–7.735; p = 0.011), and non-cardiac SETs (OR, 2.472; 95% CI, 1.110–5.507; p = 0.030) were associated with a significant risk of malignancy. Compared to SETs in other locations, cardiac SETs showed more complications (3 versus 0; p = 0.000), and open conversion rates (2 versus 0; p = 0.003). However, the proportion of GISTs of SETs in the cardia is not negligible (52.9%). Conclusions: Considering the malignancy risk of SETs, active surgical resection should be considered in old age and/or location in the non-cardiac area. However, in young patients, SETs located in the gastric cardia have a considerably benign nature and are associated with poor short-term surgical outcomes. An individualized surgical approach for asymptomatic small SETs according to the gastric location is warranted. MDPI 2022-08-13 /pmc/articles/PMC9409778/ /pubmed/36012971 http://dx.doi.org/10.3390/jcm11164733 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Kim, Sung Gon Eom, Bang Wool Yoon, Hongman Kook, Myeong-Cheorl Kim, Young-Woo Ryu, Keun Won Necessity of Individualized Approach for Gastric Subepithelial Tumor Considering Pathologic Discrepancy and Surgical Difficulty Depending on the Gastric Location |
title | Necessity of Individualized Approach for Gastric Subepithelial Tumor Considering Pathologic Discrepancy and Surgical Difficulty Depending on the Gastric Location |
title_full | Necessity of Individualized Approach for Gastric Subepithelial Tumor Considering Pathologic Discrepancy and Surgical Difficulty Depending on the Gastric Location |
title_fullStr | Necessity of Individualized Approach for Gastric Subepithelial Tumor Considering Pathologic Discrepancy and Surgical Difficulty Depending on the Gastric Location |
title_full_unstemmed | Necessity of Individualized Approach for Gastric Subepithelial Tumor Considering Pathologic Discrepancy and Surgical Difficulty Depending on the Gastric Location |
title_short | Necessity of Individualized Approach for Gastric Subepithelial Tumor Considering Pathologic Discrepancy and Surgical Difficulty Depending on the Gastric Location |
title_sort | necessity of individualized approach for gastric subepithelial tumor considering pathologic discrepancy and surgical difficulty depending on the gastric location |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409778/ https://www.ncbi.nlm.nih.gov/pubmed/36012971 http://dx.doi.org/10.3390/jcm11164733 |
work_keys_str_mv | AT kimsunggon necessityofindividualizedapproachforgastricsubepithelialtumorconsideringpathologicdiscrepancyandsurgicaldifficultydependingonthegastriclocation AT eombangwool necessityofindividualizedapproachforgastricsubepithelialtumorconsideringpathologicdiscrepancyandsurgicaldifficultydependingonthegastriclocation AT yoonhongman necessityofindividualizedapproachforgastricsubepithelialtumorconsideringpathologicdiscrepancyandsurgicaldifficultydependingonthegastriclocation AT kookmyeongcheorl necessityofindividualizedapproachforgastricsubepithelialtumorconsideringpathologicdiscrepancyandsurgicaldifficultydependingonthegastriclocation AT kimyoungwoo necessityofindividualizedapproachforgastricsubepithelialtumorconsideringpathologicdiscrepancyandsurgicaldifficultydependingonthegastriclocation AT ryukeunwon necessityofindividualizedapproachforgastricsubepithelialtumorconsideringpathologicdiscrepancyandsurgicaldifficultydependingonthegastriclocation |