Abstract
BackgroundGastric cancer is a frequent malignant tumor worldwide and its early detection is crucial for curing the disease and enhancing patients’ survival rate. This study aimed to assess whether the multi-disciplinary team (MDT) can improve the detection rate of early gastric cancer (EGC).MethodsThe detection rate of EGC at the Digestive Endoscopy Center, Affiliated Hospital, Zunyi Medical College, China between September 2013 and September 2015 was analyzed. MDT for the diagnosis of EGC in the hospital was established in September 2014. The study was divided into 2 time periods: September 1, 2013 to August 31, 2014 (period 1) and September 1, 2014 to September 1, 2015 (period 2).ResultsA total of 60,800 patients’ gastroscopies were performed during the two years. 61 of these patients (0.1%) were diagnosed as EGC, accounting for 16.44% (61/371) of total patients with gastric cancer. The EGC detection rate before MDT (period 1) was 0.05% (16/29403), accounting for 9.09% (16/176) of total patients with gastric cancer during this period. In comparison, the EGC detection rate during MDT (period 2) was 0.15% (45/31397), accounting for 23% (45/195) of total patients with gastric cancer during this period (P < 0.05). Univariate and multivariate logistic analyses showed that intensive gastroscopy for high risk patients of gastric cancer enhanced the detection rate of EGC in cooperation with Department of Pathology (OR = 10.1, 95% CI 2.39–43.3, P < 0.05).ConclusionMDT could improve the endoscopic detection rate of EGC.
Highlights
Gastric cancer is a frequent malignant tumor worldwide and its early detection is crucial for curing the disease and enhancing patients’ survival rate
Painless and comfortable gastroscopy was made to facilitate careful examination; mucus decomposing, antifoaming and spasmolytic agents were used to improve the visibility of the gastric mucosa; and standardized gastroscopy photography, white light endoscopy (WLE) indigo carmine staining, narrow band imaging (NBI), and magnifying endoscopy were performed to improve the detection of early gastric cancer (EGC)
Rates of EGC detection From September 1, 2013 to September 1, 2015, the gastroscopies of a total of 60,800 patients were performed in the Digestive Endoscopy Center of Affiliated Hospital of Zunyi Medical College
Summary
Gastric cancer is a frequent malignant tumor worldwide and its early detection is crucial for curing the disease and enhancing patients’ survival rate. This study aimed to assess whether the multi-disciplinary team (MDT) can improve the detection rate of early gastric cancer (EGC). Every year about 738,000 people die of gastric cancer, and the overall 5-year survival rate is about 20% [1, 2]. Di et al BMC Gastroenterology (2017) 17:147 with about 400,000 added gastric cancer patients and about 350,000 patients died of this malignant disease each year, and the new and dead patients account for 40% of patients with gastric cancer in the world [16], while the detection rate of EGC in China accounts only for 5% to 20% of total gastric cancer. The low detection rate of EGC in China may be related to endoscopist’s awareness, experience, ability to identify EGC, and and related to lack of coordination and cooperation between different departments in the Hospital including Gastroenterology, Pathology, Gastrointestinal Surgery, and Endoscopy Center
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