Characteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms

Abstract. Background:. With the wide application of endoscopic submucosal dissection (ESD) for early gastric neoplasms, metachronous gastric neoplasms (MGN) have gradually become a concern. This study aimed to analyze the characteristics of MGN and evaluate the treatment and follow-up outcomes of MG...

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Autores principales:	Shan-Shan Xu, Ning-Li Chai, Xiao-Wei Tang, En-Qiang Linghu, Sha-Sha Wang, Bao Li, Yuan-Yuan Ji
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/08051ef828aa4364b6c9ba5ba32e4fcf
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spelling	oai:doaj.org-article:08051ef828aa4364b6c9ba5ba32e4fcf2021-11-25T07:57:20ZCharacteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms0366-69992542-564110.1097/CM9.0000000000001762https://doaj.org/article/08051ef828aa4364b6c9ba5ba32e4fcf2021-11-01T00:00:00Zhttp://journals.lww.com/10.1097/CM9.0000000000001762https://doaj.org/toc/0366-6999https://doaj.org/toc/2542-5641Abstract. Background:. With the wide application of endoscopic submucosal dissection (ESD) for early gastric neoplasms, metachronous gastric neoplasms (MGN) have gradually become a concern. This study aimed to analyze the characteristics of MGN and evaluate the treatment and follow-up outcomes of MGN patients. Methods:. A total of 814 patients were retrospectively enrolled. All these patients were treated by ESD for early gastric cancer or gastric dysplasia between November 2006 and September 2019 at The First Medical Center of Chinese People's Liberation Army General Hospital. The risk factors for MGN were analyzed using Cox hazard proportional model. Moreover, the cumulative incidence, the correlation of initial lesions and MGN lesions, and the treatment and follow-up outcomes of MGN patients were analyzed. Results:. A total of 4.5% (37/814) of patients had MGN after curative ESD. The 3-, 5-, and 7-year cumulative incidences of MGN were 3.5%, 5.1%, and 6.9%, respectively, and ultimately reaching a plateau of 11.3% at 99 months after ESD. There was no significant correlation between initial lesions and MGN lesions in terms of gross type (P = 0.178), location (long axis: P = 0.470; short axis: P = 0.125), and histological type (P = 0.832). Cox multivariable analysis found that initial multiplicity was the only independent risk factor of MGN (hazard ratio: 4.3, 95% confidence interval: 2.0–9.4, P < 0.001). Seventy-three percent of patients with MGN were treated by endoscopic resection. During follow-up, two patients with MGN died of gastric cancer with lymph node metastasis. The disease-specific survival rate was significantly lower in patients with MGN than that in patients without MGN (94.6% vs. 99.6%, P = 0.006). Conclusions:. The MGN rate gradually increased with follow-up time within 99 months after curative gastric ESD. Thus, regular and long-term surveillance endoscopy may be helpful, especially for patients with initial multiple neoplasms.Shan-Shan XuNing-Li ChaiXiao-Wei TangEn-Qiang LinghuSha-Sha WangBao LiYuan-Yuan JiWolters KluwerarticleMedicineRENChinese Medical Journal, Vol 134, Iss 21, Pp 2603-2610 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Shan-Shan Xu Ning-Li Chai Xiao-Wei Tang En-Qiang Linghu Sha-Sha Wang Bao Li Yuan-Yuan Ji Characteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms
description	Abstract. Background:. With the wide application of endoscopic submucosal dissection (ESD) for early gastric neoplasms, metachronous gastric neoplasms (MGN) have gradually become a concern. This study aimed to analyze the characteristics of MGN and evaluate the treatment and follow-up outcomes of MGN patients. Methods:. A total of 814 patients were retrospectively enrolled. All these patients were treated by ESD for early gastric cancer or gastric dysplasia between November 2006 and September 2019 at The First Medical Center of Chinese People's Liberation Army General Hospital. The risk factors for MGN were analyzed using Cox hazard proportional model. Moreover, the cumulative incidence, the correlation of initial lesions and MGN lesions, and the treatment and follow-up outcomes of MGN patients were analyzed. Results:. A total of 4.5% (37/814) of patients had MGN after curative ESD. The 3-, 5-, and 7-year cumulative incidences of MGN were 3.5%, 5.1%, and 6.9%, respectively, and ultimately reaching a plateau of 11.3% at 99 months after ESD. There was no significant correlation between initial lesions and MGN lesions in terms of gross type (P = 0.178), location (long axis: P = 0.470; short axis: P = 0.125), and histological type (P = 0.832). Cox multivariable analysis found that initial multiplicity was the only independent risk factor of MGN (hazard ratio: 4.3, 95% confidence interval: 2.0–9.4, P < 0.001). Seventy-three percent of patients with MGN were treated by endoscopic resection. During follow-up, two patients with MGN died of gastric cancer with lymph node metastasis. The disease-specific survival rate was significantly lower in patients with MGN than that in patients without MGN (94.6% vs. 99.6%, P = 0.006). Conclusions:. The MGN rate gradually increased with follow-up time within 99 months after curative gastric ESD. Thus, regular and long-term surveillance endoscopy may be helpful, especially for patients with initial multiple neoplasms.
format	article
author	Shan-Shan Xu Ning-Li Chai Xiao-Wei Tang En-Qiang Linghu Sha-Sha Wang Bao Li Yuan-Yuan Ji
author_facet	Shan-Shan Xu Ning-Li Chai Xiao-Wei Tang En-Qiang Linghu Sha-Sha Wang Bao Li Yuan-Yuan Ji
author_sort	Shan-Shan Xu
title	Characteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms
title_short	Characteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms
title_full	Characteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms
title_fullStr	Characteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms
title_full_unstemmed	Characteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms
title_sort	characteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/08051ef828aa4364b6c9ba5ba32e4fcf
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_version_	1718413600286048256

Characteristics of metachronous gastric neoplasms after curative endoscopic submucosal dissection for early gastric neoplasms

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