Prevalence and Predictive Factors of Malignant Potential in Resected Gastric Subepithelial Tumors

ABSTRACT

BACKGROUND/AIMS: EUS is a useful method to differentiate malignant from benign gastric subepithelial tumors (SETs) and to determine resection. However, this results in unnecessary resections of benign gastric SETs. The aim of our study is 1. to investigate clinical factors that may predict malignancy in gastric SET and 2. to determine how many of them have malignant potential in resected gastric SETs. MATERIALS AND METHODS: We retrospectively identified 111 patients who underwent pathologic confirmation for gastric SETs by surgical (104/111, 93.6%) and endoscopic resection between February 2003 and April 2012 and analyzed the clinical, EUS findings and final pathologic diagnosis for these patients. RESULTS: The diagnostic accuracy of EUS for SETs was 58.6% (51/87) and the rate of resection for benign SETs was 31.5% (35/111). In multivariate analysis, old age (> or =65), as well as tumor size (> or =2 cm) and location (upper or middle) were significant predictive factors for malignant potential of gastric SETs. CONCLUSIONS: One-third of endoscopic and surgical resections are performed for benign SETs. Patient's age, tumor size, and location should be considered before resection of gastric SETs. In addition, more accurate tools for histologic confirmation should be developed in order to avoid unnecessary resection.