Background and Aims
The aim of this study was to identify the incidence of recurrent lesions after endoscopic
submucosal dissection (ESD) and to determine whether scheduled endoscopic surveillance
might control their development and treatment.
Methods
We reviewed the clinical data of patients who underwent gastric ESD between March
2007 and April 2014.
Results
A total of 1347 patients who underwent curative ESD for early gastric cancer that
met the expanded indication for ESD were analyzed. Of these, recurrence at the previous
ESD site occurred in 39 patients, whereas recurrence in the stomach at a site other
than the ESD site occurred in 102 patients. Older age, intestinal metaplasia, flat
or depressed lesions, and ESD criteria were associated with recurrence in the stomach
in places other than the ESD site. The annual incidence was .84% for recurrence at
the previous ESD site and 2.48% for recurrence in the stomach at other than the ESD
site. In cases of local recurrence and metachronous lesions, there was a significant
difference between the short- and long-surveillance interval group (≤12 months vs
>12 months) in the proportions of recurrent adenocarcinoma (31.9% vs 60.9%, P = .021), additional gastrectomy (7.1% vs 46.2%, P = .033), and size (8.92 ± 4.17 mm vs 18.08 ± 10.47 mm, P = .010).
Conclusions
Scheduled endoscopy surveillance is necessary for detecting recurrent lesions. In
addition, scheduled endoscopy surveillance might help to detect recurrent lesions
at a stage early enough for a curative resection.
Abbreviations:
AGC (advanced gastric cancer), APC (argon plasma coagulation), CI (confidence interval), EGC (early gastric cancer), ESD (endoscopic submucosal dissection), OR (odds ratio)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Gastrointestinal EndoscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Endoscopic resection of early gastric cancer.Gastric Cancer. 2007; 10: 1-11
- Endoscopic submucosal dissection of early gastric cancer.J Gastroenterol. 2006; 41: 929-942
- Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers.Gastric Cancer. 2000; 3: 219-225
- Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer.Gastric Cancer. 2009; 12: 148-152
- Short- and long-term outcomes of endoscopic submucosal dissection for undifferentiated early gastric cancer.Endoscopy. 2013; 45: 703-707
- Long-term outcome of extended endoscopic submucosal dissection for early gastric cancer with differentiated histology.Clin Endosc. 2013; 46: 463-466
- Long-term outcome of early gastric cancer after endoscopic submucosal dissection: expanded indication is comparable to absolute indication.Dig Liver Dis. 2013; 45: 651-656
- Clinical validity of the expanded criteria for endoscopic resection of undifferentiated-type early gastric cancer based on long-term outcomes.Surg Endosc. 2014; 28: 639-647
- Long-term outcome comparison of endoscopic resection and surgery in early gastric cancer meeting the absolute indication for endoscopic resection.Gastrointest Endosc. 2015; 81: 333-341
- Comparison of quality of life and worry of cancer recurrence between endoscopic and surgical treatment for early gastric cancer.Gastrointest Endosc. 2015; 82: 299-307
- Long-term survival after endoscopic resection versus surgery in early gastric cancers.Endoscopy. 2015; 47: 293-301
- Complications of endoscopic submucosal dissection for gastric noninvasive neoplasia: an analysis of 647 lesions.Surg Laparosc Endosc Percutan Tech. 2014; 24: 370-374
- Comparison on the long term outcome between endoscopic submucosal dissection and surgical treatment for undifferentiated early gastric cancer.Korean J Gastroenterol. 2014; 63: 90-98
- Endoscopic surveillance for gastric remnant cancer after early cancer surgery.Endoscopy. 2002; 34: 469-473
- Incidence of metachronous gastric cancer in the remnant stomach after synchronous multiple cancer surgery.Gastric Cancer. 2014; 17: 61-66
- Risk factors for metachronous gastric cancer in the remnant stomach after early cancer surgery.World J Surg. 2010; 34: 1548-1554
- Predictive factors for local recurrence after endoscopic resection for early gastric cancer: long-term clinical outcome in a single-center experience.Surg Endosc. 2010; 24: 2842-2849
- Metachronous gastric cancers after endoscopic resection: how effective is annual endoscopic surveillance?.Gastric Cancer. 2006; 9: 93-98
- Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer: a multicentre retrospective cohort study by Osaka University ESD study group.Gut. 2013; 62: 1425-1432
- Japanese gastric cancer treatment guidelines 2010 (version 3).Gastric Cancer. 2011; 14: 113-123
- Role of computed tomography scan for the primary surveillance of mucosal gastric cancer after complete resection by endoscopic submucosal dissection.Surg Endosc. 2014; 28: 1307-1313
- Gastric ESD: current status and future directions of devices and training.Gastrointest Endosc Clin North Am. 2014; 24: 213-233
- Synopsis on clinical practice guideline of gastric cancer in Korea: an evidence-based approach. [Korean].Korean J Gastroenterol. 2014; 63: 66-81
- Surveillance strategy based on the incidence and patterns of recurrence after curative endoscopic submucosal dissection for early gastric cancer.Endoscopy. 2015; 47: 784-793
- Rates and patterns of recurrence after curative intent resection for gastric cancer: a United States multi-institutional analysis.J Am Coll Surg. 2014; 219: 664-675
- Patterns, timing and risk factors of recurrence of gastric cancer after laparoscopic gastrectomy: reliable results following long-term follow-up.Eur J Surg Oncol. 2014; 40: 1376-1382
- Recurrence following laparoscopy-assisted gastrectomy for gastric cancer: a multicenter retrospective analysis of 1,417 patients.Ann Surg Oncol. 2010; 17: 1777-1786
- Incidence and factors associated with recurrence patterns after intended curative surgery for gastric cancer.World J Surg. 2003; 27: 153-158
- Defining the pathologic diagnosis of metaplasia, atrophy, dysplasia, and gastric adenocarcinoma.J Clin Gastroenterol. 2003; 36 (discussion S61-2): S37-S43
- Gastric atrophy, metaplasia, and dysplasia: a clinical perspective.J Clin Gastroenterol. 2003; 36 (discussion S61-2): S29-S36
- Helicobacter pylori eradication on the prevention of metachronous lesions after endoscopic resection of gastric neoplasm: a meta-analysis.PLoS One. 2015; 10: e0124725
Na HK, Ahn JY, Lee JH, et al. Endoscopic prediction of recurrence in patients with early gastric cancer after margin-negative endoscopic resection: Is follow-up biopsy necessary at endoscopic resection scar after margin-negative resection? J Gastroenterol Hepatol. Epub 2016 Jan 28.
Article info
Publication history
Published online: March 17, 2016
Accepted:
March 6,
2016
Received:
December 4,
2015
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
Copyright © 2016 by the American Society for Gastrointestinal Endoscopy
