Korean J Helicobacter Up Gastrointest Res.  2016 Mar;16(1):19-25. 10.7704/kjhugr.2016.16.1.19.

Analysis of Natural History of Upper Gastrointestinal Subepithelial Tumors and Factors Related to Tumor Growth Demonstrated by Endoscopic Ultrasonography

• Han YJ
• Kim SE
• Park MI
• Park SJ
• Moon W
• Kim JH
• Seo KI
• Kim HJ
• Jung JK

• KMID: 2159119
• DOI: http://doi.org/10.7704/kjhugr.2016.16.1.19

Abstract

BACKGROUND/AIMS
Small subepithelial tumors (SETs) are often found incidentally during esophagoduodenoscopy, and EUS is a useful tool for assessing SETs. This study aimed to evaluate the natural history of SETs and to clarify the predictive factors of growth using EUS.
MATERIALS AND METHODS
We retrospectively investigated SETs less than 30 mm and identified the EUS features. A significant increase in SET size was defined as a lengthening of more than 25% of the longest diameter in the last follow-up EUS features compared with the initial study.
RESULTS
A total of 99 patients with 105 upper gastrointestinal SETs were enrolled. The mean follow-up period for SETs was 22.8 months. Among the 105 SETs, 12 (11.4%) were significantly larger at follow-up. Univariate analysis revealed that the presence of hypoechoic areas was associated with significant SET growth (P=0.021). In multivariate analysis, the presence of hypoechoic areas (OR, 8.96; 95% CI, 1.89~42.54) and anechoic areas (OR, 7.85; 95% CI, 1.09~56.37) were related with significant growth of SETs. Six of the 12 SETs showing significant growth were removed, and identified as gastrointestinal stromal tumors.
CONCLUSIONS
Majority of small SETs showed no significant increase during follow-up. Presence of hypoechoic areas and anechoic areas were associated with SET growth. Therefore, small SETs with hypoechoic area or anechoic area may be considered for regular follow-up in the clinical field.

Keyword

Subepithelial tumors; Endoscopic ultrasonography; Natural history

MeSH Terms

Endosonography*
Follow-Up Studies
Gastrointestinal Stromal Tumors
Humans
Multivariate Analysis
Natural History*
Retrospective Studies