Conventional 30-day or in-hospital mortality underestimates the true burden of postoperative death after gastrectomy. This study aimed to characterize post-discharge mortality and its evolving determinants following gastric cancer surgery. We retrospectively analyzed patients who underwent gastrectomy for primary gastric cancer at Seoul National University Hospital between 2013 and 2019. Mortality data were updated through national death registry linkage with complete follow-up of at least 5 years. In-hospital deaths were reviewed using medical records, while out-of-hospital deaths were classified using death certificates and family interviews. Cox regression analyses were performed across sequential postoperative intervals up to 5 years. Among 4802 patients included in the analysis, overall mortality within 6 months was 1.2
Primary KIT exon 13 and 17 mutations are rare in gastrointestinal stromal tumors (GISTs), and data on their response to imatinib are limited. We evaluated the clinical characteristics and outcomes. We analyzed 1524 patients with metastatic or recurrent GIST treated with first-line imatinib between 2005 and 2024 at Asan Medical Center, Seoul, Korea. Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were compared between the primary KIT exon 13 or 17 and exon 11 group. ORR was assessed only in patients with measurable lesions, whereas PFS and OS were analyzed in all patients. Germline sequencing was performed when available. Twenty-seven patients (1.8
Gastric cancer (GC) remains a major global health burden, and early detection is essential for improving patient outcomes. Although GC screening has been widely implemented in East Asian countries with a high disease burden, the optimal screening strategy for low- to moderate-prevalence regions remains unclear. To address this gap, the Asia Pacific Gastroesophageal Cancer Congress (APGCC) convened an international consensus meeting to develop evidence-based recommendations for improving the detection of non-cardia gastric cancer (NCGC). The APGCC working group developed 11 clinical questions (CQs) addressing GC screening, with a particular focus on NCGC. For each CQ, assigned authors conducted literature reviews using PubMed and prepared evidence summaries and draft recommendations. Consensus was achieved through a two-round modified Delphi process involving 37 international voting members. The consensus recommendations addressed population-based screening, screening modalities, identification of high-risk individuals, quality indicators for esophagogastroduodenoscopy (EGD), image-enhanced endoscopy, and artificial intelligence-assisted endoscopy. Population-based endoscopic screening is not recommended in low- to moderate-prevalence regions because of insufficient evidence. However, if screening is performed, EGD is preferred over upper gastrointestinal series for the detection of early NCGC in asymptomatic individuals. The recommendations also emphasize the importance of high-quality endoscopic examinations, risk-stratified screening using serum biomarkers, and the appropriate integration of advanced endoscopic technologies. These APGCC consensus recommendations provide practical guidance for improving the early detection of NCGC in low- to moderate-prevalence regions. This consensus also highlights important evidence gaps and establishes a framework for future research and the development of region-specific GC screening strategies.
Intraoperative hemorrhage is the most frequent complication of endoscopic submucosal dissection (ESD). We aim to develop and externally validate a preoperative risk-scoring model for predicting intraoperative hemorrhage during ESD for gastric neoplasms. Patients who underwent ESD for gastric neoplasms from four endoscopy centers were enrolled in this retrospective study, with 1123 patients in derivation cohort and 345 patients in validation cohort. In derivation cohort, univariable and multivariable logistic regression analysis were used to identify independent preoperative predictors of intraoperative hemorrhage. A risk-scoring model was created by assigning weighted points to selected predictors. External validation was conducted to analyse the discrimination and calibration of the prediction model. A prediction model for intraoperative hemorrhage included 5 variables: upper-third location (5 points), large lesion size (≥ 25 mm) (4 points), current HP infection (3 points), junior endoscopist (3 points) and middle-third location (2 points). Patients were stratified into low- (0–2 points), intermediate- (3–4 points), high- (5–6 points), and very high-risk (≥ 7 points) groups, with corresponding bleeding rates of 4.8
