Although several studies pertaining to the natural history of subepithelial tumors have been published, they have been limited by small sample size and relatively short follow-up. The natural history of subepithelial lesions has not been clearly elucidated, and the appropriate management strategy for small subepithelial tumors is still controversial.
A research article to be published on January 28, 2010 in the World Journal of Gastroenterology addresses this question. The research team from South Korea reviewed the medical records of 104 159 patients who underwent upper gastrointestinal endoscopy at the Center for Health Promotion of Samsung Medical Center between 1996 and 2003.
Their results showed that of the 252 lesions, 244 (96.8%) were unchanged. And endoscopic surveillance can be an appropriate strategy for lesions < 1 cm. Further prospective, multicenter studies with long-term follow-up would help to validate these surveillance programs.