title: Endoscopic surveillance can increase the chance of resectability and endoscopic treatment in gastric cancer.
abstract: OBJECTIVE
  Little is known about the effects of periodic endoscopic screening before detection of primary gastric cancer. We compared clinical outcomes in patients who did and did not undergo endoscopy before diagnosis.
  
  
  METHODS
  Between January 2009 and November 2011, 769 patients were referred to Asan Medical Center after diagnosis of gastric cancer. Clinical outcomes were compared in patients who had (n=512) and had not (n=257) undergone endoscopic screening before diagnosis of gastric cancer. Factors about resectability and possibility of endoscopic resection were analyzed.
  
  
  RESULTS
  In the nonexamined group, 225 patients (87.5%) had resectable gastric cancers and were treated surgically (n=151, 67.1%) or by endoscopic resection (n=74, 32.9%). In the examined group, 493 (96.3%) had resectability and were resected surgically (n=243, 49.3%) or endoscopically (n=250, 50.7%). Multivariate analysis showed that symptoms, no endoscopic screening, and lower serum albumin were associated with unresectability. Of the 718 resectable tumors, 394 underwent surgery and 324 underwent endoscopic resection. Multivariate analysis showed that older age, no symptoms, ≤1 year interval endoscopy, and higher serum albumin were associated with endoscopic resection.
  
  
  CONCLUSIONS
  Previous endoscopy can increase gastric cancer resectability. Moreover, a ≤1 year interval from endoscopic examination can increase the possibility of endoscopic resection.
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Ahn
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Nam
authors.forename: Hwoon-yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Kwi-Sook
authors.initials: KS
authors.lastname: Choi
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kim
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.forename: Ho June
authors.initials: HJ
authors.lastname: Song
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Seungbong
authors.initials: S
authors.lastname: Han
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy; D005773:Gastroscopy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors