Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 51 (3), 253-259

Metachronous Gastric Cancer Following Curative Endoscopic Resection of Early Gastric Cancer


Metachronous Gastric Cancer Following Curative Endoscopic Resection of Early Gastric Cancer

Seiichiro Abe et al. Clin Endosc.


This review article summarizes knowledge about metachronous gastric cancer (MGC) occurring after curative endoscopic resection (ER) of early gastric cancer (EGC), treatment outcomes of patients who developed MGC, and efficacy of Helicobacter pylori eradication to prevent MGC. The incidence of MGC following curative ER increases over time and is higher than in patients undergoing gastrectomy. Increasing age and multifocal EGC are independent risk factors for developing MGC. An MGC following curative ER is usually a small (<20 mm) and differentiated intramucosal cancer. Most MGC lesions are found at an early stage on semiannual or annual surveillance endoscopy and are successfully treated by further ER, with excellent long-term outcomes. Eradication of H. pylori may reduce the risk of MGC following ER of EGC, but further prospective studies with long-term outcomes are required. Surveillance endoscopy following gastric ER should be continued indefinitely, due to the risk of MGC even after successful H. pylori eradication. Risk stratification and tailored endoscopic surveillance schedules need to be developed.

Keywords: Endoscopic mucosal resection; Endoscopic resection; Surveillance endoscopy; Helicobacter pylori; Metachronous gastric cancer.

Conflict of interest statement

Conflicts of Interest: The authors have no financial conflicts of interest.

Similar articles

See all similar articles

Cited by 6 PubMed Central articles

See all "Cited by" articles


    1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–E386. - PubMed
    1. Nashimoto A, Akazawa K, Isobe Y, et al. Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry. Gastric Cancer. 2013;16:1–27. - PMC - PubMed
    1. Gotoda T, Yanagisawa A, Sasako M, et al. 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. - PubMed
    1. Hirasawa T, Gotoda T, Miyata S, et al. Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer. Gastric Cancer. 2009;12:148–152. - PubMed
    1. Japanese Gastric Cancer Association Japanese gastric cancer treatment guidelines 2010 (ver. 3) Gastric Cancer. 2011;14:113–123. - PubMed