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Impact of the Interval between Previous Endoscopic Exam and Diagnosis on the Mortality and Treatment Modality of Undifferentiated-Type Gastric Cancer

  • Lee, Ayoung (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Chung, Hyunsoo (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Lee, Hyuk-Joon (Department of Surgery and Cancer Research Institute, Gastric Cancer Center, Seoul National University Cancer Hospital, Seoul National University College of Medicine) ;
  • Cho, Soo-Jeong (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Kim, Jue Lie (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Ahn, Hye Seong (Department of Surgery, Gastric Cancer Center, Seoul National University Cancer Hospital, Seoul National University College of Medicine) ;
  • Suh, Yun-Suhk (Department of Surgery, Gastric Cancer Center, Seoul National University Cancer Hospital, Seoul National University College of Medicine) ;
  • Kong, Seong-Ho (Department of Surgery, Gastric Cancer Center, Seoul National University Cancer Hospital, Seoul National University College of Medicine) ;
  • Choe, Hwi Nyeong (Department of Nursing, Seoul National University Hospital) ;
  • Yang, Han-Kwang (Department of Surgery and Cancer Research Institute, Gastric Cancer Center, Seoul National University Cancer Hospital, Seoul National University College of Medicine) ;
  • Kim, Sang Gyun (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
  • Received : 2021.04.17
  • Accepted : 2021.06.21
  • Published : 2021.06.30

Abstract

Purpose: The impact of the interval between previous endoscopy and diagnosis on the treatment modality or mortality of undifferentiated (UD)-type gastric cancer is unclear. This study aimed to investigate the effect of endoscopic screening interval on the stage, cancer-related mortality, and treatment methods of UD-type gastric cancer. Materials and Methods: We reviewed the medical records of newly diagnosed patients with UD gastric cancer in 2013, in whom the interval between previous endoscopy and diagnosis could be determined. The patients were classified into different groups according to the period from the previous endoscopy to diagnosis (<12 months, 12-23 months, 24-35 months, ≥36 months, and no history of endoscopy), and the outcomes were compared between the groups. In addition, patients who underwent endoscopic and surgical treatment were reclassified based on the final treatment results. Results: The number of enrolled patients was 440, with males representing 64.1% of the study population; 11.8% of the participants reported that they had undergone endoscopy for the first time in their cancer diagnosis. The percentage of stage I cancer at diagnosis significantly decreased as the interval from the previous endoscopy to diagnosis increased (65.4%, 63.2%, 64.2%, 45.9%, and 35.2% for intervals of <12 months, 12-23 months, 24-35 months, ≥36 months, and no previous endoscopy, respectively, P<0.01). Cancer-related mortality was significantly lower for a 3-year interval of endoscopy (P<0.001). Conclusions: A 3-year interval of endoscopic screening reduces gastric-cancer-related mortality, particularly in cases of UD histology.

Keywords

Acknowledgement

We would like to thank Editage (www.editage.co.kr) for English language editing.

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