Occurrence of metachronous or synchronous lesions after endoscopic treatment of gastric epithelia dysplasia- impact of histologic features of background mucosa

Park, Won-Young; Lee, So-Jeong; Kim, Young-Keum; Kim, Ahrong; Park, Do Youn; Lee, Bong-Eun; Song, Geun-Am; Kim, Gwang Ha

doi:10.1016/j.prp.2017.10.022

Cited by 9 publications

(7 citation statements)

References 23 publications

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“…After a curative ER, the risk of LNM is low or very low, but there is a very low risk of recurrence and a moderate risk of metachronous lesions during follow-up (10 %-20 %) [192,[225][226][227][228][229][230][231]. There is evidence that Helicobacter pylori eradication decreases the risk of metachronous lesions and thus eradication is recommended if the patient has active H. pylori infection [232].…”

Section: Stomachmentioning

confidence: 99%

“…There is evidence that Helicobacter pylori eradication decreases the risk of metachronous lesions and thus eradication is recommended if the patient has active H. pylori infection [232]. No other strategies showed benefit in decreasing risk of metachronous lesions, but there is consistent evidence that older patients and patients with synchronous or multiple lesions at diagnosis and/or with extensive preneoplastic conditions are at higher risk [192,[225][226][227][228][229][230][231]. However, to date there are no data showing that these risk factors should influence surveillance intervals.…”

Section: Stomachmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

Pimentel‐Nunes

Libânio

Bastiaansen³

et al. 2022

Endoscopy

293

212

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Main recommendationsESGE recommends that the evaluation of superficial gastrointestinal (GI) lesions should be made by an experienced endoscopist, using high definition white-light and chromoendoscopy (virtual or dye-based).ESGE does not recommend routine performance of endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET)-CT prior to endoscopic resection.ESGE recommends endoscopic submucosal dissection (ESD) as the treatment of choice for most superficial esophageal squamous cell and superficial gastric lesions.For Barrett’s esophagus (BE)-associated lesions, ESGE suggests the use of ESD for lesions suspicious of submucosal invasion (Paris type 0-Is, 0-IIc), for malignant lesions > 20 mm, and for lesions in scarred/fibrotic areas.ESGE does not recommend routine use of ESD for duodenal or small-bowel lesions.ESGE suggests that ESD should be considered for en bloc resection of colorectal (but particularly rectal) lesions with suspicion of limited submucosal invasion (demarcated depressed area with irregular surface pattern or a large protruding or bulky component, particularly if the lesions are larger than 20 mm) or for lesions that otherwise cannot be completely removed by snare-based techniques.ESGE recommends that an en bloc R0 resection of a superficial GI lesion with histology no more advanced than intramucosal cancer (no more than m2 in esophageal squamous cell carcinoma), well to moderately differentiated, with no lymphovascular invasion or ulceration, should be considered a very low risk (curative) resection, and no further staging procedure or treatment is generally recommended.ESGE recommends that the following should be considered to be a low risk (curative) resection and no further treatment is generally recommended: an en bloc R0 resection of a superficial GI lesion with superficial submucosal invasion (sm1), that is well to moderately differentiated, with no lymphovascular invasion, of size ≤ 20 mm for an esophageal squamous cell carcinoma or ≤ 30 mm for a stomach lesion or of any size for a BE-related or colorectal lesion, and with no lymphovascular invasion, and no budding grade 2 or 3 for colorectal lesions.ESGE recommends that, after an endoscopically complete resection, if there is a positive horizontal margin or if resection is piecemeal, but there is no submucosal invasion and no other high risk criteria are met, this should be considered a local-risk resection and endoscopic surveillance or re-treatment is recommended rather than surgery or other additional treatment.ESGE recommends that when there is a diagnosis of lymphovascular invasion, or deeper infiltration than sm1, or positive vertical margins, or undifferentiated tumor, or, for colorectal lesions, budding grade 2 or 3, this should be considered a high risk (noncurative) resection, and complete staging and strong consideration for additional treatments should be considered on an individual basis in a multidisciplinary discussion.ESGE recommends scheduled endoscopic surveillance with high definition white-light and chromoendoscopy (virtual or dye-based) with biopsies of only the suspicious areas after a curative ESD.

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Section: Stomachmentioning

confidence: 99%

Section: Stomachmentioning

confidence: 99%

Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

Pimentel‐Nunes

Libânio

Bastiaansen³

et al. 2022

Endoscopy

293

212

View full text Add to dashboard Cite

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“…Risk factors for metachronous recurrence after ER of gastric neoplasm were male sex, older age, multiple initial EGCs, family history of gastric cancer, and persistent H. pylori infection. 15,16 The present study shows that the family history of gastric cancer could play an important role in metachronous recurrence after ESD is performed for gastric neoplasm. However, H. pylori eradication after ESD did not significantly reduce the incidence of metachronous recurrence.…”

Section: Discussionmentioning

confidence: 63%

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

Choe

Shim

Kim

et al. 2019

Korean J Helicobacter Up Gastrointest Res

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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.

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“…Gastric obstruction could also be found in several reports [ 14 , 15 ], but not in this study. It was often speculated that the GCP developed in patients who had undergone gastric surgery [ 16 , 17 ]. However, more and more cases were reported in an unoperated stomach [ 18 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

Computed tomography features and clinical characteristics of gastritis cystica profunda

Wang

Liang

et al. 2022

Insights Imaging

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Background The diagnostic evidence of gastritis cystica profunda (GCP) are not adequately described due to its extremely low morbidity. This study aimed to analyze and summarize the comprehensive CT features and clinical characteristics of patients with GCP. Results Nineteen patients were enrolled, including eight men and eleven women, with a mean age of 55.53 years. Only one patient had the history of gastric polypectomy. Among the nineteen cases, two cases were in the gastric cardia, four in the gastric fundus, eight in the gastric body and five in the gastric antrum. The shapes were sphere in thirteen patients, hemisphere in five patients and diffuse in one patient. The mean size of eighteen local lesions was 1.63 cm. The cystic changes in submucosa were detected in fifteen patients. Compared with the pancreas, most GCP lesions were hypo-attenuated on unenhanced CT (n = 8), in arterial phase (AP) (n = 17) and venous phase (VP) (n = 11). Fifteen patients had the peak enhancement in VP and two in AP. The rim-like enhancement with central low attenuation was clearly observed in thirteen patients. For the GCP accompanied by adenocarcinoma, the enhancement peak was present in AP and the gradual expansion of enhancement area was in VP. All patients underwent surgical or endoscopic resection. Sixteen cases had remission of symptoms and no recurrence. Conclusions The careful analysis of CT features and clinical characteristics can provide support for deepening the understanding of the GCP. However, a more accurate diagnosis depends on histopathological features.

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Occurrence of metachronous or synchronous lesions after endoscopic treatment of gastric epithelia dysplasia- impact of histologic features of background mucosa

Cited by 9 publications

References 23 publications

Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

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

Computed tomography features and clinical characteristics of gastritis cystica profunda

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