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Clinical Outcomes of Metachronous Gastric Cancer after Endoscopic Resection for Early Gastric Cancer

BACKGROUND/AIMS: Patients treated with endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) are at risk of developing metachronous gastric cancer (MGC). The aim of this study was to evaluate the clinical outcomes of MGC after ESD for EGC between the re-ESD and surgery groups. METHOD...

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Autores principales: Kim, Jue Lie, Kim, Sang Gyun, Kim, Jung, Park, Jae Yong, Yang, Hyo-Joon, Kim, Hyun Ju, Chung, Hyunsoo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Editorial Office of Gut and Liver 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096239/
https://www.ncbi.nlm.nih.gov/pubmed/31158949
http://dx.doi.org/10.5009/gnl18575
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author Kim, Jue Lie
Kim, Sang Gyun
Kim, Jung
Park, Jae Yong
Yang, Hyo-Joon
Kim, Hyun Ju
Chung, Hyunsoo
author_facet Kim, Jue Lie
Kim, Sang Gyun
Kim, Jung
Park, Jae Yong
Yang, Hyo-Joon
Kim, Hyun Ju
Chung, Hyunsoo
author_sort Kim, Jue Lie
collection PubMed
description BACKGROUND/AIMS: Patients treated with endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) are at risk of developing metachronous gastric cancer (MGC). The aim of this study was to evaluate the clinical outcomes of MGC after ESD for EGC between the re-ESD and surgery groups. METHODS: In total, data from 1,510 patients who underwent ESD for EGC from January 2005 to May 2014 were retrospectively reviewed, and data from 112 patients with MGC were analyzed according to the type of treatment, namely, re-ESD and surgery. The clinicopathological factors affecting the subsequent treatment and outcomes of MGC were evaluated. RESULTS: The median duration to the development of MGC was 47 months. In multivariate analysis, lower body mass index (BMI) (p=0.037) and multiplicity (p=0.014) of index cases were significantly associated with subsequent surgery for MGC. In cases of MGC, a diffuse or mixed-type Lauren classification (p=0.009), the depth of tumor mucosal invasion (p=0.001), and an upper stomach location (p=0.049) were associated with surgery. Overall survival was significantly shorter in the surgery group than in the re-ESD group after treatment for MGC (log-rank test, p=0.01). CONCLUSIONS: Lower BMI and multiplicity of index cancers were significantly associated with the surgical resection of MGC. Close follow-up is needed to minimize additional treatment for cases at high risk of advanced MGC after ESD for EGC.
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spelling pubmed-70962392020-04-02 Clinical Outcomes of Metachronous Gastric Cancer after Endoscopic Resection for Early Gastric Cancer Kim, Jue Lie Kim, Sang Gyun Kim, Jung Park, Jae Yong Yang, Hyo-Joon Kim, Hyun Ju Chung, Hyunsoo Gut Liver Original Article BACKGROUND/AIMS: Patients treated with endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) are at risk of developing metachronous gastric cancer (MGC). The aim of this study was to evaluate the clinical outcomes of MGC after ESD for EGC between the re-ESD and surgery groups. METHODS: In total, data from 1,510 patients who underwent ESD for EGC from January 2005 to May 2014 were retrospectively reviewed, and data from 112 patients with MGC were analyzed according to the type of treatment, namely, re-ESD and surgery. The clinicopathological factors affecting the subsequent treatment and outcomes of MGC were evaluated. RESULTS: The median duration to the development of MGC was 47 months. In multivariate analysis, lower body mass index (BMI) (p=0.037) and multiplicity (p=0.014) of index cases were significantly associated with subsequent surgery for MGC. In cases of MGC, a diffuse or mixed-type Lauren classification (p=0.009), the depth of tumor mucosal invasion (p=0.001), and an upper stomach location (p=0.049) were associated with surgery. Overall survival was significantly shorter in the surgery group than in the re-ESD group after treatment for MGC (log-rank test, p=0.01). CONCLUSIONS: Lower BMI and multiplicity of index cancers were significantly associated with the surgical resection of MGC. Close follow-up is needed to minimize additional treatment for cases at high risk of advanced MGC after ESD for EGC. Editorial Office of Gut and Liver 2020-03-15 2019-11-11 /pmc/articles/PMC7096239/ /pubmed/31158949 http://dx.doi.org/10.5009/gnl18575 Text en Copyright © 2020 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Jue Lie
Kim, Sang Gyun
Kim, Jung
Park, Jae Yong
Yang, Hyo-Joon
Kim, Hyun Ju
Chung, Hyunsoo
Clinical Outcomes of Metachronous Gastric Cancer after Endoscopic Resection for Early Gastric Cancer
title Clinical Outcomes of Metachronous Gastric Cancer after Endoscopic Resection for Early Gastric Cancer
title_full Clinical Outcomes of Metachronous Gastric Cancer after Endoscopic Resection for Early Gastric Cancer
title_fullStr Clinical Outcomes of Metachronous Gastric Cancer after Endoscopic Resection for Early Gastric Cancer
title_full_unstemmed Clinical Outcomes of Metachronous Gastric Cancer after Endoscopic Resection for Early Gastric Cancer
title_short Clinical Outcomes of Metachronous Gastric Cancer after Endoscopic Resection for Early Gastric Cancer
title_sort clinical outcomes of metachronous gastric cancer after endoscopic resection for early gastric cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096239/
https://www.ncbi.nlm.nih.gov/pubmed/31158949
http://dx.doi.org/10.5009/gnl18575
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