Korean J Helicobacter Up Gastrointest Res.  2019 Sep;19(3):184-192. 10.7704/kjhugr.2019.19.3.184.

Risk Factors for Metachronous Recurrence after Endoscopic Submucosal Dissection of a Gastric Neoplasm

• Choe AR
• Shim KN
• Kim TO
• Kim SY
• Lim J
• Tae CH
• Moon CM
• Kim SE
• Jung HK
• Jung SA

• KMID: 2469332
• DOI: http://doi.org/10.7704/kjhugr.2019.19.3.184

Abstract

BACKGROUND/AIMS
Although endoscopic submucosal dissection (ESD) is an accepted treatment method for gastric neoplasm worldwide, metachronous recurrence often occurs. Here, we evaluated the risk factors for metachronous recurrence after ESD of gastric dysplasia or adenocarcinoma and also examined the effects of Helicobacter pylori (H. pylori) eradication.
MATERIALS AND METHODS
Among 400 patients who underwent endoscopic resection from February 2005 to December 2014 at Ewha Womans University Hospital, the medical records of 180 patients were retrospectively reviewed.
RESULTS
The enrolled patients included 118 men and 62 women, and their median age was 61.7±10.3 years. During a median follow-up period of 34.5 months, metachronous recurrence occurred in 21 (11.7%) patients. Multivariate analyses revealed that H. pylori eradication did not have any preventive effects on metachronous recurrence. A family history of gastric cancer was the only risk factor for metachronous recurrence after ESD of the gastric neoplasm.
CONCLUSIONS
Metachronous recurrence was found to be related to family history of gastric cancer. However, H. pylori eradication had no preventive effects on metachronous recurrence after ESD of a gastric neoplasm. Therefore, intensive surveillance is required for patients who undergo ESD of a gastric neoplasm and have a family history of gastric cancer.

Keyword

Endoscopic submucosal dissection; Metachronous recurrence; Stomach neoplasms

MeSH Terms

Adenocarcinoma
Female
Follow-Up Studies
Helicobacter pylori
Humans
Male
Medical Records
Methods
Multivariate Analysis
Recurrence*
Retrospective Studies
Risk Factors*
Stomach Neoplasms*