ID: 3521051 LONG-TERM COURSE OF GASTRIC SUBMUCOSAL TUMORS BY TUMOR SIZE: GROWTH SPEED AND RISK FACTORS

e15631 Background: Gastric Submucosal tumors (SMTs) were incidentally discovered esophagogastroduodenoscopy (EGD). However, they have not been studied in detail of epidemiology. Furthermore, no treatment strategy for SMTs has been established with few studies looking into long-term outcomes. The aim of this study is to clarify the clinical features and long-term outcomes of gastric SMT at a single institute for 10-year period. Methods: We performed a total of 5307 EGDs and detected 188 gastric SMTs during 1998. All clinical data including incidence, size and location in stomach were analyzed for the medical records. A retrospective review was conducted for 10-year period for 109 patients and 79 patients were excluded because of simultaneous surgery (3), disappear in follow- up EGD (27), lost of follow-up (49). Results: Gastric SMTs were detected 188 (81 males, 107 females) of 5307 patients (3.5%). Majority size of SMTs was less than 1cm (64%) and SMTs<2cm were 91%. 56% of SMTs located middle one third of stomach, and half (22%) of the remaining SMTs were detected at upper and lower one third, respectively. In 10-year follow-up, 83 of 109 patients were alive at December 2008. One patient was dead of SMT and the remaining 25 patients were dead of other disease till December 2008. Enlargement of SMT was observed in 2 of 109 SMTs (1.8%). Both of them underwent surgical resection and diagnosed as gastrointestinal stromal tumors (GIST). One patient was annually monitored by endoscopy, from 0.6cm to 1.5cm during 4 years, without recurrence for 6 years after surgical intervention. Another didn't undergo regular endoscopy, from 1.8cm to 8cm during 2 years, with recurrence, and consequently died of SMT. Conclusions: The incidence of SMTs is 3.5%, majority (91%) is small (<2cm), and frequent location is middle one third of stomach. Most of SMTs might be managed conservatively, but regular endoscopy is required. No significant financial relationships to disclose.

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Short- and Long-Term Outcomes of Endoscope-Assisted Laparoscopic Wedge Resection for Gastric Submucosal Tumors Adjacent to Esophagogastric Junction

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-017-3628-2 ◽

2017 ◽

Vol 22 (3) ◽

pp. 402-413 ◽

Cited By ~ 1

Author(s):

Xin Ye ◽

Jianchun Yu ◽

Weiming Kang ◽

Zhiqiang Ma ◽

Zhigang Xue

Keyword(s):

Esophagogastric Junction ◽

Wedge Resection ◽

Long Term Outcomes ◽

Laparoscopic Wedge Resection ◽

Submucosal Tumors ◽

Gastric Submucosal Tumors ◽

Short And Long Term

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Comparison of Outcomes After Primary Laparoscopic Versus Open Approach for T1b/T2 Gallbladder Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.758319 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jiasheng Cao ◽

Yong Wang ◽

Bin Zhang ◽

Jiahao Hu ◽

Win Topatana ◽

...

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Tumor Size ◽

Open Approach ◽

Gallbladder Stone ◽

Long Term Outcomes ◽

Recurrence Rates ◽

Subgroup Analyses ◽

Potential Risk Factors

ObjectivesThe primary laparoscopic approach (PLA) for T1b/T2 gallbladder cancer (GBC) remains contradicted. We aimed to compare the perioperative and long-term outcomes after PLA versus open approach (OA) for T1b/T2 GBC.MethodsPatients with resected T1b/T2 GBC were selected from our hospital between January 2011 and August 2018. Overall survival (OS), disease-free survival (DFS), and several secondary outcomes were used to evaluate safety and effectiveness. Subgroup analyses were performed to identify significant risk factors for OS/DFS in GBC patients undergoing PLA/OA.ResultsA total of 114 patients who underwent OA (n = 61) or PLA (n = 53) were included in the study. The percent of PLA cases was increased over time from 40.0% in 2011 to 70.0% in 2018 (p < 0.05). There was no significant difference in OS [hazard ratio (HR), 1.572; 95% confidence interval (CI), 0.866–2.855; p = 0.13] and DFS (HR, 1.225; 95% CI, 0.677–2.218; p = 0.49). No significance was found for intraoperative drainage placement (p = 0.253), intraoperative blood loss (p = 0.497), operation time (p = 0.105), postoperative hospitalization (p = 0.797), positive LNs (p = 0.494), total harvested LNs (p = 0.067), and recurrence rates (P = 0.334). Subgroup analyses demonstrated no significance of conversion rates after PLA (all p > 0.05). Patients undergoing PLA with good/poor OS would have similar recurrence rates (p = 0.402). Positive LNs (p = 0.032) and tumor differentiation (p = 0.048) were identified as risk factors for OS after PLA, while positive LNs (p = 0.005) was identified for OS after OA. Moreover, age (p = 0.013), gallbladder stone (p = 0.008), tumor size (p = 0.028), and positive LNs (p = 0.044) were potential risk factors for DFS after OA.ConclusionsPLA for T1b/T2 GBC was comparable to OA in terms of perioperative and long-term outcomes. Less positive LNs and well-differentiated tumors were independent predictors for better OS after PLA, and less positive LNs were also identified for better OS after OA. Additionally, younger age, without gallbladder stone, smaller tumor size, and less positive LNs were potential risk factors for better DFS after OA.

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Long-term prognostic implications of risk factors associated with tumor size: a case study of women regularly attending screening

Breast Cancer Research ◽

10.1186/s13058-018-0962-6 ◽

2018 ◽

Vol 20 (1) ◽

Cited By ~ 3

Author(s):

Fredrik Strand ◽

Keith Humphreys ◽

Johanna Holm ◽

Mikael Eriksson ◽

Sven Törnberg ◽

...

Keyword(s):

Risk Factors ◽

Tumor Size ◽

Factors Associated ◽

Prognostic Implications

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PERI-OPERATIVE RISK FACTORS FOR LONG TERM INTELLIGENCE IN CHILDREN WITH POSTOPERATIVE CEREBELLAR MUTISM SYNDROME AFTER MEDULLOBLASTOMA SURGERY

10.22541/au.162006901.15964446/v1 ◽

2021 ◽

Author(s):

Femke Aarsen ◽

MarieLise van Veelen-Vincent ◽

Marita Partanen ◽

Coriene Catsman-Berrevoets

Keyword(s):

Risk Factors ◽

Tumor Size ◽

Negative Impact ◽

Operative Risk ◽

Cerebellar Mutism ◽

Post Surgery ◽

Younger Age ◽

Age At Surgery ◽

Swallowing Problems

Objective: 7-50% of children with medulloblastoma (MB) develop postoperative cerebellar mutism syndrome (pCMS). pCMS has a short-term negative impact on intelligence, but results on long-term outcomes are contradictory. The aim of this study was to assess long-term effects of pCMS in MB patients on aspects of intelligence (IQ) and its perioperative risk factors. Methods: In this single centre retrospective cohort study, 31 children with MB were included of which 14 had pCMS. Peri-operative risk factors included brainstem invasion, vermis incision, pre-and post-operative hydrocephalus, tumor size, duration and severity of pCMS, neurological symptoms on day 10 after surgery, mean body temperature (BT) on days 1-4 post surgery, and age at resection. Age appropriate Wechsler Intelligence tests were assessed within a structured follow up programme. Results: No significant differences in IQ scores were found between pCMS and non pCMS groups. The pCMS group had a clinically relevant difference of 10 points when compared to age norms on verbal IQ (VIQ). Bilateral pyramidal and swallowing problems were risk factors for lower performance in this group. In the overall group, tumor size, younger age at surgery, and raised mean BT on days 1-4 post-surgery were negatively correlated with aspects of IQ. Conclusions: We found a clinically significant reduction of VIQ in the pCMS patient group. pCMS patients with a larger tumor size, younger age at surgery, a higher mean BT in the first days after surgery, bilateral pyramidal symptoms, and swallowing problems 10 days post-surgery are more at risk for VIQ deficits at long-term.

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Clinical outcomes of non-exposed endoscopic wall-inversion surgery for gastric submucosal tumors: long-term follow-up and functional results

Gastric Cancer ◽

10.1007/s10120-019-00985-1 ◽

2019 ◽

Vol 23 (1) ◽

pp. 154-159 ◽

Cited By ~ 2

Author(s):

Junya Aoyama ◽

Osamu Goto ◽

Hirofumi Kawakubo ◽

Shuhei Mayanagi ◽

Kazumasa Fukuda ◽

...

Keyword(s):

Clinical Outcomes ◽

Functional Results ◽

Submucosal Tumors ◽

Gastric Submucosal Tumors ◽

Long Term Follow Up

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Factors predicting technical difficulties during endoscopic submucosal excavation for gastric submucosal tumor

Journal of International Medical Research ◽

10.1177/03000605211029808 ◽

2021 ◽

Vol 49 (9) ◽

pp. 030006052110298

Author(s):

Jia Liu ◽

Yuyong Tan ◽

Deliang Liu ◽

Chenjie Li ◽

Meixian Le ◽

...

Keyword(s):

Risk Factors ◽

Submucosal Tumor ◽

En Bloc Resection ◽

Bloc Resection ◽

En Bloc ◽

Delayed Bleeding ◽

Submucosal Tumors ◽

Gastric Submucosal Tumors ◽

Inexperienced Surgeon ◽

Endoscopic Submucosal Excavation

Objective Endoscopic submucosal excavation (ESE) has been established as an effective method for removal of gastric submucosal tumors (SMTs). The aim of the present study was to explore risk factors for technical difficulties in ESE. Methods In this retrospective study, we collected clinical data from patients who underwent ESE for gastric SMTs. Difficult ESE was defined as a procedure time ≥90 minutes, piecemeal resection, and/or occurrence of major adverse events. Univariate and multivariate analyses were performed to explore the risk factors for a difficult ESE. Results ESE was successfully performed in 96.5% (195/202) of patients from April 2011 to December 2019. The average tumor size was 17.41 mm, and en bloc resection was achieved in 97.4% of patients (190/195). Five patients (2.56%, 5/195) had complications, including two with delayed bleeding, two with fever, and one with chest pain accompanying ST-T changes in an electrocardiogram. Twenty-four patients (11.88%, 24/202) had a difficult ESE. Logistic analysis showed that outgrowth behavior and an inexperienced surgeon were risk factors for a difficult ESE. Conclusion ESE may be safe and effective to treat patients with gastric SMTs. Outgrowth behavior and an inexperienced surgeon were risk factors for a difficult ESE.

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