Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer: A multicentre retrospective cohort study by Osaka University ESD study group

Motohiko Kato, Tsutomu Nishida, Katsumi Yamamoto, Shiro Hayashi, Shinji Kitamura, Takamasa Yabuta, Toshiyuki Yoshio, Takeshi Nakamura, Masato Komori, Naoki Kawai, Akihiro Nishihara, Fumihiko Nakanishi, Masanori Nakahara, Hideharu Ogiyama, Kazuo Kinoshita, Takuya Yamada, Hideki Iijima, Masahiko Tsujii, Tetsuo Takehara

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Background: After endoscopic submucosal dissection (ESD) of early gastric cancer (EGC), patients are at high risk for synchronous or metachronous multiple gastric cancers. Objective: To elucidate the time at which multiple cancers develop and to determine whether scheduled endoscopic surveillance might control their development. Design: A multicentre retrospective cohort study from 12 hospitals was conducted. Patients with EGC who underwent ESD with en bloc margin-negative curative resection were included. Synchronous cancer was classified as concomitant cancer or missed cancer. The cumulative incidence of metachronous cancers and overall survival rate were calculated using the Kaplan-Meier method. Results: From April 1999 to December 2010, 1258 patients met the inclusion criteria. Synchronous or metachronous multiple cancers were detected in 175 patients (13.9%) during a mean of 26.8 months. Among the 110 synchronous cancers, 21 were missed at the time of the initial ESD. Many of the missed lesions existed in the upper third of the stomach and the miss rate was associated with the endoscopist's inexperience (<500 oesophagogastroduodenoscopy cases). The cumulative incidence of metachronous cancers increased linearly and the mean annual incidence rate was 3.5%. The incidence rate did not differ between patients with or without Helicobacter pylori eradication. Four lesions (0.32%) were detected as massively invading cancers during the follow-up. Conclusions: Nineteen per cent of synchronous cancers were not detected until the initial ESD. The incidence rate of metachronous cancer after ESD was constant. Scheduled endoscopic surveillance showed that almost all recurrent lesions were treatable by endoscopic resection.

Original languageEnglish
Pages (from-to)1425-1432
Number of pages8
JournalGut
Volume62
Issue number10
DOIs
Publication statusPublished - 2013 Oct 1
Externally publishedYes

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Stomach Neoplasms
Cohort Studies
Retrospective Studies
Neoplasms
Incidence
Endoscopic Mucosal Resection
Digestive System Endoscopy
Helicobacter pylori
Stomach
Survival Rate

ASJC Scopus subject areas

  • Gastroenterology

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Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer : A multicentre retrospective cohort study by Osaka University ESD study group. / Kato, Motohiko; Nishida, Tsutomu; Yamamoto, Katsumi; Hayashi, Shiro; Kitamura, Shinji; Yabuta, Takamasa; Yoshio, Toshiyuki; Nakamura, Takeshi; Komori, Masato; Kawai, Naoki; Nishihara, Akihiro; Nakanishi, Fumihiko; Nakahara, Masanori; Ogiyama, Hideharu; Kinoshita, Kazuo; Yamada, Takuya; Iijima, Hideki; Tsujii, Masahiko; Takehara, Tetsuo.

In: Gut, Vol. 62, No. 10, 01.10.2013, p. 1425-1432.

Research output: Contribution to journalArticle

Kato, M, Nishida, T, Yamamoto, K, Hayashi, S, Kitamura, S, Yabuta, T, Yoshio, T, Nakamura, T, Komori, M, Kawai, N, Nishihara, A, Nakanishi, F, Nakahara, M, Ogiyama, H, Kinoshita, K, Yamada, T, Iijima, H, Tsujii, M & Takehara, T 2013, 'Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer: A multicentre retrospective cohort study by Osaka University ESD study group', Gut, vol. 62, no. 10, pp. 1425-1432. https://doi.org/10.1136/gutjnl-2011-301647
Kato, Motohiko ; Nishida, Tsutomu ; Yamamoto, Katsumi ; Hayashi, Shiro ; Kitamura, Shinji ; Yabuta, Takamasa ; Yoshio, Toshiyuki ; Nakamura, Takeshi ; Komori, Masato ; Kawai, Naoki ; Nishihara, Akihiro ; Nakanishi, Fumihiko ; Nakahara, Masanori ; Ogiyama, Hideharu ; Kinoshita, Kazuo ; Yamada, Takuya ; Iijima, Hideki ; Tsujii, Masahiko ; Takehara, Tetsuo. / Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer : A multicentre retrospective cohort study by Osaka University ESD study group. In: Gut. 2013 ; Vol. 62, No. 10. pp. 1425-1432.
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abstract = "Background: After endoscopic submucosal dissection (ESD) of early gastric cancer (EGC), patients are at high risk for synchronous or metachronous multiple gastric cancers. Objective: To elucidate the time at which multiple cancers develop and to determine whether scheduled endoscopic surveillance might control their development. Design: A multicentre retrospective cohort study from 12 hospitals was conducted. Patients with EGC who underwent ESD with en bloc margin-negative curative resection were included. Synchronous cancer was classified as concomitant cancer or missed cancer. The cumulative incidence of metachronous cancers and overall survival rate were calculated using the Kaplan-Meier method. Results: From April 1999 to December 2010, 1258 patients met the inclusion criteria. Synchronous or metachronous multiple cancers were detected in 175 patients (13.9{\%}) during a mean of 26.8 months. Among the 110 synchronous cancers, 21 were missed at the time of the initial ESD. Many of the missed lesions existed in the upper third of the stomach and the miss rate was associated with the endoscopist's inexperience (<500 oesophagogastroduodenoscopy cases). The cumulative incidence of metachronous cancers increased linearly and the mean annual incidence rate was 3.5{\%}. The incidence rate did not differ between patients with or without Helicobacter pylori eradication. Four lesions (0.32{\%}) were detected as massively invading cancers during the follow-up. Conclusions: Nineteen per cent of synchronous cancers were not detected until the initial ESD. The incidence rate of metachronous cancer after ESD was constant. Scheduled endoscopic surveillance showed that almost all recurrent lesions were treatable by endoscopic resection.",
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T1 - Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer

T2 - A multicentre retrospective cohort study by Osaka University ESD study group

AU - Kato, Motohiko

AU - Nishida, Tsutomu

AU - Yamamoto, Katsumi

AU - Hayashi, Shiro

AU - Kitamura, Shinji

AU - Yabuta, Takamasa

AU - Yoshio, Toshiyuki

AU - Nakamura, Takeshi

AU - Komori, Masato

AU - Kawai, Naoki

AU - Nishihara, Akihiro

AU - Nakanishi, Fumihiko

AU - Nakahara, Masanori

AU - Ogiyama, Hideharu

AU - Kinoshita, Kazuo

AU - Yamada, Takuya

AU - Iijima, Hideki

AU - Tsujii, Masahiko

AU - Takehara, Tetsuo

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Background: After endoscopic submucosal dissection (ESD) of early gastric cancer (EGC), patients are at high risk for synchronous or metachronous multiple gastric cancers. Objective: To elucidate the time at which multiple cancers develop and to determine whether scheduled endoscopic surveillance might control their development. Design: A multicentre retrospective cohort study from 12 hospitals was conducted. Patients with EGC who underwent ESD with en bloc margin-negative curative resection were included. Synchronous cancer was classified as concomitant cancer or missed cancer. The cumulative incidence of metachronous cancers and overall survival rate were calculated using the Kaplan-Meier method. Results: From April 1999 to December 2010, 1258 patients met the inclusion criteria. Synchronous or metachronous multiple cancers were detected in 175 patients (13.9%) during a mean of 26.8 months. Among the 110 synchronous cancers, 21 were missed at the time of the initial ESD. Many of the missed lesions existed in the upper third of the stomach and the miss rate was associated with the endoscopist's inexperience (<500 oesophagogastroduodenoscopy cases). The cumulative incidence of metachronous cancers increased linearly and the mean annual incidence rate was 3.5%. The incidence rate did not differ between patients with or without Helicobacter pylori eradication. Four lesions (0.32%) were detected as massively invading cancers during the follow-up. Conclusions: Nineteen per cent of synchronous cancers were not detected until the initial ESD. The incidence rate of metachronous cancer after ESD was constant. Scheduled endoscopic surveillance showed that almost all recurrent lesions were treatable by endoscopic resection.

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