Endoscopic resection of gastric submucosal tumors: a single-center retrospective study.

BACKGROUND

Gastric submucosal tumors (G-SMTs) refer to protuberant lesions originating from the muscularis mucosae, submucosa, or muscularis propria. Endoscopic resection (ER) has been adopted as a treatment option for G-SMTs. However, the indications for ER remain inconsistent across guidelines. This study aimed to provide further clinical evidence supporting the role of ER in the management of G-SMTs.

METHODS

This retrospective study included 531 of 949 patients with G-SMTs undergoing ER between June 2015 and June 2024. Baseline and lesion characteristics were collected. Among patients diagnosed as having gastrointestinal stromal tumors (GISTs), clinical features were compared in patients who achieved complete ER (ER0) with incomplete ER (ER1). Follow-up information was available for a subset of patients and was used to evaluate recurrence outcomes.

RESULTS

The mean age of patients was 56.4 ± 11.0 years, and the mean tumor size was 1.56 ± 0.97 cm. The mean procedural time for patients was 58 ± 32 min. Postoperative pathological evaluation revealed that GISTs and leiomyomas were the most common pathological types, accounting for 53.7% and 32.8% of cases. To evaluate the risk factors associated with piecemeal resection of GISTs, the patients were divided into 2 groups (ER0 and ER1). On univariate analysis, larger tumor size (P <.001), extraluminal growth pattern (P =.031), and high-risk grade (P =.02) were significantly associated with incomplete resection, whereas multivariable analysis identified tumor size as the only independent risk factor (odds ratio, 3.389; 95% CI, 1.799-6.385; P <.001). During follow-up, only 2 patients experienced recurrence, and overall recurrence-free survival remained high.

CONCLUSION

ER is a safe and effective therapeutic method for specific G-SMTs. For GISTs, tumor size is the main factor associated with incomplete resection.