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, 23 (24), 4407-4415

Risk Factors for Metachronous Gastric Carcinoma Development After Endoscopic Resection of Gastric Dysplasia: Retrospective, Single-Center Study


Risk Factors for Metachronous Gastric Carcinoma Development After Endoscopic Resection of Gastric Dysplasia: Retrospective, Single-Center Study

Hee Seok Moon et al. World J Gastroenterol.


Aim: To determine the gastric adenocarcinoma (GAC) occurrence rate and related factors, we evaluated the follow-up results of patients confirmed to have gastric dysplasia after endoscopic resection (ER).

Methods: We retrospectively analyzed the medical records, endoscopic examination records, endoscopic procedure records, and histological records of 667 cases from 641 patients who were followed-up for at least 12 mo, from among 1273 patients who were conformed to have gastric dysplasia after Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) of gastric mucosal lesions between January 2007 and August 2013 at the Chungnam National University Hospital.

Results: The mean follow-up period was 33.8 mo, and the median follow-up period was 29 mo (range: 12-87). During the follow-up period, the occurrence of metachronous GAC was 4.0% (27/667). The mean and median interval periods between the occurrence of metachronous GAC and endoscopic treatment of gastric dysplasia were 36.3 and 34 mo, respectively (range: 16-71). The factors related to metachronous GAC occurrence after ER for gastric dysplasia were male sex (5.3% vs 1.0%), open-type atrophic gastritis (9.5% vs 3.4%), intestinal metaplasia (6.8% vs 2.4%), and high-grade dysplasia (HGD; 8.4% vs 3.2%). Among them, male sex [OR: 5.05 (1.18-21.68), P = 0.029], intestinal metaplasia [OR: 2.78 (1.24-6.23), P = 0.013], and HGD [OR: 2.70 (1.16-6.26), P = 0.021] were independent related factors in multivariate analysis. Furthermore, 24 of 27 GAC cases (88.9%) occurred at sites other than the previous resection sites, and 3 (11.1%) occurred at the same site as the previous resection site.

Conclusion: Male sex, intestinal metaplasia, and HGD were significantly related to the occurrence of metachronous GAC after ER of gastric dysplasia, and most GACs occurred at sites other than the previous resection sites.

Keywords: Endoscopic mucosal resection; Gastric dysplasia; Neoplasms; Second primary; Stomach neoplasms.

Conflict of interest statement

Conflict-of-interest statement: We have no conflicts of interest regarding the current paper.


Figure 1
Figure 1
Flowchart of gastric lesion. Initially, 667 cases were enrolled, of which 8 were local recurrences and were excluded. Finally, 659 lesions were evaluated. GA: Gastric adenoma; GAC: Gastric adenocarcinoma; EMR: Endoscopic mucosal resection; ESD: endoscopic submucosal dissection.
Figure 2
Figure 2
Cumulative incidence of metachronous neoplasm after endoscopic resection of gastric dysplasia by Kaplan-Meier analysis.

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    1. Stolte M. The new Vienna classification of epithelial neoplasia of the gastrointestinal tract: advantages and disadvantages. Virchows Arch. 2003;442:99–106. - PubMed
    1. Kimura K, Takemoto T. An Endoscopic Recognition of the Atrophic Border and its Significance in Chronic Gastritis. Endoscopy. 1969;1:87–97.
    1. Fukuta N, Ida K, Kato T, Uedo N, Ando T, Watanabe H, Shimbo T. Endoscopic diagnosis of gastric intestinal metaplasia: a prospective multicenter study. Dig Endosc. 2013;25:526–534. - PubMed
    1. Kim JJ, Lee JH, Jung HY, Lee GH, Cho JY, Ryu CB, Chun HJ, Park JJ, Lee WS, Kim HS, et al. EMR for early gastric cancer in Korea: a multicenter retrospective study. Gastrointest Endosc. 2007;66:693–700. - PubMed
    1. Nasu J, Doi T, Endo H, Nishina T, Hirasaki S, Hyodo I. Characteristics of metachronous multiple early gastric cancers after endoscopic mucosal resection. Endoscopy. 2005;37:990–993. - PubMed

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