Characteristics of Metachronous Multiple Early Gastric Cancers after Endoscopic Mucosal Resection

Nasu, Junichirou; Doi, Takehiko; Endo, Hidehiko; Nishina, Takuo; Shoji, Hirokazu; Hyodo, Ichinosuke

doi:10.1055/s-2005-870198

Cited by 149 publications

(136 citation statements)

References 10 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…Similarly to the previous study [12], this study showed that new lesions tend to develop in the same third of the stomach with the same histologic features as the primary ones. Endoscopic resection can be applied as long as the new lesions are detected early enough to meet the criteria for it.…”

Section: Discussionsupporting

confidence: 86%

“…In a previous study of metachronous gastric cancer after endoscopic resection, the overall incidence was reported to be 8.2 % during an average of 3.1 years of follow-up, and the cumulative 3-year incidence of metachronous gastric cancer was 5.9 % [19]. Another study reported that metachronous gastric cancers had an overall incidence of 14 % during a median of 57 months of follow-up [12], and yet another study showed the incidence of synchronous and metachronous multiple gastric cancers after endoscopic resection to be 14.5 and 8.5 %, respectively [15]. As highgrade dysplasia was also included in this study, the rate of synchronous or metachronous tumor development might be lower than that found in previous studies because of the lower invasiveness or multiplicity of dysplastic epithelium than invasive carcinoma.…”

Section: Discussionmentioning

confidence: 97%

“…In one study, metachronous gastric cancer tended to develop in the same third of the stomach as the primary lesion with similar macroscopic and differentiated type [12]. Another two studies showed that atrophy in the background gastric mucosa was associated with the development of metachronous gastric cancer [13,14].…”

Section: Introductionmentioning

confidence: 99%

“…In previous studies, the incidence of synchronous or metachronous gastric cancer after surgical resection was reported to range from as high as 4.8-20.9 % [4][5][6][7][8][9] to as low as 1.8-2.4 % [10,11]. In another study, the incidences of synchronous and metachronous gastric cancer after endoscopic resection were 11 and 14 %, respectively [12].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk factors for synchronous or metachronous tumor development after endoscopic resection of gastric neoplasms

et al. 2014

View full text Add to dashboard Cite

Background Despite many advantages, the development of synchronous or metachronous neoplasm is one of the main concerns with endoscopic resection. We aimed to clarify the independent risk factors for synchronous or metachronous gastric neoplasm. Methods We retrospectively reviewed the medical records of all patients who had undergone endoscopic resection for gastric high-grade dysplasia or early gastric cancer between April 2001 and February 2011. Results Among 971 subjects, 56 synchronous neoplasms and 42 metachronous neoplasms developed during 12-131 months of follow-up. In univariate analysis, age over 65 years, male gender, absence of Helicobacter pylori infection, lower third location, mucosal atrophy, and intestinal metaplasia were related to multiple gastric neoplasms. In multivariate analysis, absence of H. pylori infection [odds ratio (OR) 1.610, 95 % confidence interval (CI) 1.038-2.497)], lower third location (OR 1.704, 95 % CI 1.070-2.713), and intestinal metaplasia (OR 4.461, 95 % CI 1.382-14.401) were independent risk factors for multiple gastric neoplasms. For synchronous neoplasm, primary tumor size less than 1 cm was the only independent risk factor. For metachronous neoplasm, absence of H. pylori infection (OR 2.416, 95 % CI 1.214-4.810) was found to be the only independent risk factor. H. pylori eradication was found to be unrelated to the development of metachronous gastric neoplasms. Conclusions For tumors located in the antrum and accompanied by intestinal metaplasia, meticulous endoscopic evaluation with close follow-up after endoscopic resection is recommended.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for synchronous or metachronous tumor development after endoscopic resection of gastric neoplasms

et al. 2014

View full text Add to dashboard Cite

show abstract

“…With regard to tumor location, it has been known that multiple gastric cancers arise more frequently in the middle and lower than in the upper third of the stomach [9-11, 21, 23]. In addition, during whole stomach endoscopic surveillance after endoscopic mucosal resection for early cancer, the incidence rate of metachronous cancer in the upper, middle, and lower third of the stomach has been reported to be 17, 33, and 50 %, respectively [24]. These results suggest that the middle and lower third of the stomach have foci of multicentric carcinogenesis more than the upper third of the stomach.…”

Section: Discussionmentioning

confidence: 99%

Incidence of metachronous gastric cancer in the remnant stomach after synchronous multiple cancer surgery

et al. 2013

View full text Add to dashboard Cite

Background In the preoperative evaluation for gastric cancer, high-resolution endoscopic technologies allow us to detect small accessory lesions. However, it is not known if the gastric remnant after partial gastrectomy for synchronous multiple gastric cancers has a greater risk for metachronous cancer. The purpose of this study was to determine the incidence of metachronous cancer in this patient subset compared with that after solitary cancer surgery. Methods Data on a consecutive series of 1,281 patients gastrectomized for early gastric cancer from 1991 to 2007 were analyzed retrospectively. The 715 gastric remnants after distal gastrectomy were periodically surveyed by endoscopic examination in Shikoku Cancer Center. Among those surveyed cases, 642 patients were pathologically diagnosed with solitary lesion (SO group) and 73 patients with synchronous multiple lesions (MU group) at the time of the initial surgery. Results In the follow-up period, 15 patients in the SO group and 3 patients in the MU group were diagnosed as having metachronous cancer in the gastric remnant. The cumulative 4-year incidence rate was 1.9 % in the SO group and 5.5 % in the MU group. The difference did not reach the significant level by the log-rank test. ConclusionsThe incidence of metachronous cancer is higher after multiple cancer surgery; however, the difference is not statistically significant.

show abstract

Assessment of Outcomes From 1-Year Surveillance After Detection of Early Gastric Cancer Among Patients at High Risk in Japan

et al. 2022

View full text Add to dashboard Cite

IMPORTANCE Single endoscopic examination often misses early gastric cancer (GC), even when both high-definition white light imaging and narrow-band imaging are used. It is unknown whether new GC can be detected approximately 1 year after intensive index endoscopic examination. OBJECTIVE To examine whether new GC can be detected approximately 1 year after intensive index endoscopic examination using both white light and narrow-band imaging. DESIGN, SETTING, AND PARTICIPANTSThis case-control study was a preplanned secondary analysis of a randomized clinical trial involving 4523 patients with a high risk of GC who were enrolled

show abstract

Characteristics of Metachronous Multiple Early Gastric Cancers after Endoscopic Mucosal Resection

Abstract: Annual endoscopic examinations can preserve the whole stomach in most patients with early gastric cancer after successful EMR.

Cited by 149 publications

References 10 publications

Risk factors for synchronous or metachronous tumor development after endoscopic resection of gastric neoplasms

Risk factors for synchronous or metachronous tumor development after endoscopic resection of gastric neoplasms

Incidence of metachronous gastric cancer in the remnant stomach after synchronous multiple cancer surgery

Assessment of Outcomes From 1-Year Surveillance After Detection of Early Gastric Cancer Among Patients at High Risk in Japan

Contact Info

Product

Resources

About