Abstract：
BACKGROUND AND AIMS:The annual incidence of metachronous cancer after endoscopic resection (ER) of early gastric cancer (EGC) is approximately 3%. However, the incidence of gastric cancer after ER of a gastric adenoma is not known. The aim of this study was to determine whether the incidence of gastric cancer after ER of a gastric adenoma was different compared with that of metachronous cancer after ER of EGC. METHODS:We retrospectively analyzed data from patients who underwent ER for gastric neoplasia from January 2005 to August 2013. Enrolled patients were divided into 2 groups: patients with low-grade dysplasia were included in the adenoma group and patients with high-grade dysplasia or invasive neoplasia were included in the EGC group. The main outcome was the incidence of gastric cancer after ER. RESULTS:At a median follow-up of 28 months, gastric cancer newly developed in 13 adenoma patients (3.6%) and in 30 EGC patients (5.1%). The incidence rate of gastric cancer after ER was 14.4 cases per 1000 person-years in adenoma patients and 18.4 cases per 1000 person-years in EGC patients (P = .309 by the log-rank test). The hazard ratio of metachronous neoplasia in adenoma patients compared with EGC patients was 0.97 (95% confidence interval, 0.62-1.53). Metachronous tumors with invasion beyond the muscularis mucosa were more frequent in adenoma patients than in EGC patients (7/35 [20.0%] vs 3/63 [4.8%], P = .017). CONCLUSION:The incidence of gastric cancer after ER for gastric adenoma was not significantly different from that of EGC. If further prospective studies confirm these findings, careful endoscopic surveillance with the same level of intensity should be considered for both gastric adenoma and EGC patients after ER.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Yoon SB,Park JM,Lim CH,Kim JS,Cho YK,Lee BI,Lee IS,Kim SW,Choi MGdoi
10.1016/j.gie.2015.10.024subject
Has Abstractpub_date
2016-06-01 00:00:00pages
1176-83issue
6eissn
0016-5107issn
1097-6779pii
S0016-5107(15)03040-0journal_volume
83pub_type
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