J Korean Med Sci.  2017 Mar;32(3):421-426. 10.3346/jkms.2017.32.3.421.

Risk Factors for Metachronous Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer

• Chung CS
• Woo HS
• Chung JW
• Jeong SH
• Kwon KA
• Kim YJ
• Kim KO
• Park DK

• KMID: 2366637
• DOI: http://doi.org/10.3346/jkms.2017.32.3.421

Abstract

Although endoscopic submucosal dissection (ESD) is widely accepted as a curative treatment method for early gastric cancer (EGC) worldwide, metachronous recurrence often occurs after ESD for EGC. However, there are insufficient data about the role of Helicobacter pylori (H. pylori) infection and other risk factors for recurrence. We aimed to compare the metachronous lesion in the H. pylori persistent group and the eradicated group, and to identify risk factors for metachronous lesion. We retrospectively analyzed 782 patients who underwent ESD between January 2008 and December 2013. We excluded patients with dysplasia or patients who were not tested for H. pylori infection. One hundred eighty-five patients were enrolled. We studied risk factors for recurrence, and used survival analysis to test. There were 24 patients with metachronous recurrence after ESD for EGC among the group. The incidence of metachronous gastric lesions after ESD for EGC developed more in the over 70-year-old group (P = 0.025) and more in the H. pylori persistent group (P = 0.008). In conclusion, H. pylori infection and old age are independent risk factors for metachronous gastric lesions after ESD in EGC.

Keyword

Gastric Cancer; Endoscopic Submucosal Dissection; Metachronous Recurrence

MeSH Terms

Aged
Helicobacter pylori
Humans
Incidence
Methods
Recurrence*
Retrospective Studies
Risk Factors*
Stomach Neoplasms*

Figure

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  Fig. 1 Patients and study design. ESD = endoscopic submucosal dissection, EGC = early gastric cancer.

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  Fig. 2 Cumulative incidence of the metachronous recurrence (H. pylori). ESD = endoscopic submucosal dissection.

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  Fig. 3 Cumulative incidence of the metachronous recurrence (age). ESD = endoscopic submucosal dissection.

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