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

研究成果: Article査読

142 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)1425-1432
ページ数8
ジャーナルGut
62
10
DOI
出版ステータスPublished - 2013 10月
外部発表はい

ASJC Scopus subject areas

  • 消化器病学

フィンガープリント

「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」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル