Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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The pattern of metachronous recurrence after endoscopic submucosal dissection for gastric adenocarcinoma and dysplasias

  • Sunah Suk (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Yeon Joo Seo (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Dae Young Cheung (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Han Hee Lee (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jin Il Kim (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Soo-Heon Park (Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • Received : 2022.09.13
  • Accepted : 2022.11.13
  • Published : 2023.07.30
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Abstract

Background/Aims: Metachronous recurrence incidences and risk factors following endoscopic submucosal dissection (ESD) for gastric adenocarcinoma and dysplasias were investigated. Methods: Retrospective review of electronic medical records of patients who underwent gastric ESD at The Catholic University of Korea, Yeouido St. Mary's Hospital. Results: A total of 190 subjects were enrolled for analysis during the study period. The mean age was 64.4 years and the male sex occupied 73.7%. The mean observation period following ESD was 3.45 years. The annual incidence rate of metachronous gastric neoplasms (MGN) was about 3.96%. The annual incidence rate was 5.36% for the low-grade dysplasia group, 6.47% for the high-grade dysplasia group, and 2.74% for the EGC group. MGN was more frequent in the dysplasia group than in the EGC group (p<0.05). For those with MGN development, the mean time interval from ESD to MGN was 4.1 (±1.8) years. By using the Kaplan-Meier model, the estimated mean MGN free survival time was 9.97 years (95% confidence interval, 8.53-11.40) The histological types of MGN were not related to the primary histology types. Conclusions: MGN following ESD developed in 3.96% annually and MGN was more frequent in the dysplasia group. The histological types of MGN did not correlate with those of primary neoplasm.

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References

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