Korean J Gastroenterol.  2017 Nov;70(5):223-231. 10.4166/kjg.2017.70.5.223.

Development of Metachronous Tumors after Endoscopic Resection for Gastric Neoplasm according to the Baseline Tumor Grade at a Health Checkup Center

• Chung GE
• Chung SJ
• Yang JI
• Jin EH
• Park MJ
• Kim SG
• Kim JS

• KMID: 2398868
• DOI: http://doi.org/10.4166/kjg.2017.70.5.223

Abstract

BACKGROUND/AIMS
Endoscopic resection (ER) procedure has been performed widely to treat gastric neoplasms. Here, we compared the long-term prognosis based on the clinical features of three types of recurred gastric neoplasms after ER, including low-grade dysplasia (LGD), high-grade dysplasia (HGD), and early gastric carcinoma (EGC).
METHODS
Between 2003 and 2014, subjects who were diagnosed with gastric neoplasm during screening endoscopy were included. The baseline clinicopathologic and tumor recurrence were analyzed.
RESULTS
Of the 316 patients enrolled, 170 patients (53.8%) were categorized into the LGD group, 34 patients (10.8%) into the HGD group, and 112 patients (35.4%) into the EGC group. The median follow-up duration was 4.2 years. Among the total, 14 patients experienced a development of metachronous gastric cancer; 4 patients (2.3%) in the LGD group, 3 patients (8.3%) in the HGD group, and 7 patients (6.1%) in the EGC group. Metachronous gastric neoplasm had developed in 17 LGD patients (10.0%), 5 HGD patients (14.7%), and 14 EGC patients (12.5%). There was no significant difference in the incidence of metachronous gastric cancer and neoplasm among the three groups (p=0.15 and p=0.72, respectively).
CONCLUSIONS
We identified that the incidence rates of gastric neoplasm and cancer after endoscopic treatment were not significantly different between the LGD, HGD, and EGC groups.

Keyword

Gastric neoplasm; Recurrence; Adenoma

MeSH Terms

Adenoma
Endoscopy
Follow-Up Studies
Humans
Incidence
Mass Screening
Prognosis
Recurrence
Stomach Neoplasms*

Figure

• 

  Fig. 1 Enrollment process, patterns of metachronous neoplasia, and treatment modalities in each group. ER, endoscopic resection; LGD, low grade dysplasia; HGD, high grade dysplasia; EGC, early gastric cancer.

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  Fig. 2 Development of metachronous neoplasm according to the baseline tumor grade. (A) Kaplan-Meier analysis of the cumulative incidence of gastric cancer recurrence with respect to the pathologic type of the initial neoplasm. (B) Kaplan-Meier analysis of cumulative incidence of metachronous neoplasm with respect to the pathologic type of initial neoplasm. HGD, high-grade dysplasia; EGC, early gastric cancer; LGD, low-grade dysplasia.

• 

  Fig. 3 Comparison of the development of metachronous neoplasm between two groups. (A) Kaplan-Meier analysis of the cumulative incidence of gastric cancer recurrence between two groups. (B) Kaplan-Meier analysis of the cumulative incidence of metachronous neoplasm between the two groups. HGD, high-grade dysplasia; EGC, early gastric cancer; LGD, low-grade dysplasia.

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