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Surveillance strategy according to age after endoscopic resection of early gastric cancer

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Abstract

Background

Whether surveillance strategy after curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) differs in young patients is unclear. This study aimed to evaluate the risk of metachronous and extragastric recurrence in young patients with EGC after curative ESD.

Methods

We retrospectively enrolled 1237 consecutive patients who underwent curative ESD for EGC from 2005 to 2014 at a single tertiary hospital. The patients were divided into group 1 (<50 years of age, n = 86), group 2 (age 50–74, n = 985), or group 3 (≥75 years of age, n = 166). The clinical characteristics and outcomes were compared among the three age groups.

Results

Group 1 had more frequent Helicobacter pylori infection (P < 0.001), less frequent intestinal metaplasia (P = 0.021), and more frequent undifferentiated tumors (P = 0.039). Although the 5-year risk of developing metachronous recurrence appeared to be lower in group 1 (2.7%) than in groups 2 (8.6%) or 3 (8.7%), the risk became quite similar at the 7-year follow-up (6.4, 12.7, and 8.7% for groups 1, 2, and 3, respectively; P = 0.409 by log-rank test). Extragastric recurrences developed in only 2 cases in group 2 (0.2%).

Conclusions

Surveillance for metachronous and extragastric recurrence after curative ESD in patients <50 years of age should not be different from that in patients ≥50 years of age. Endoscopic surveillance for metachronous recurrence should be continued for longer than 5 years, even in young patients.

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Acknowledgements

This work was supported by a Grant from the Promising-Pioneering Researcher Program through Seoul National University in 2015.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Hyo-Joon Yang

  2. Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea

    Sang Gyun Kim, Sooyeon Oh, Jae Yong Park, Seung Jun Han, Jung Kim, Hyunsoo Chung & Hyun Chae Jung

  3. Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

    Joo Hyun Lim & Ji Min Choi

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  1. Hyo-Joon Yang
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  2. Sang Gyun Kim
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  3. Joo Hyun Lim
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  4. Ji Min Choi
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  8. Jung Kim
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Correspondence to Sang Gyun Kim.

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Disclosures

Dr. Hyo-Joon Yang, Dr. Sang Gyun Kim, Dr. Joo Hyun Lim, Dr. Ji Min Choi, Dr. Sooyeon Oh, Dr. Jae Yong Park, Dr. Seung Jun Han, Dr. Jung Kim, Dr. Hyunsoo Chung, and Dr. Hyun Chae Jung have no conflicts of interest or financial ties to disclose.

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Yang, HJ., Kim, S.G., Lim, J.H. et al. Surveillance strategy according to age after endoscopic resection of early gastric cancer. Surg Endosc 32, 846–854 (2018). https://doi.org/10.1007/s00464-017-5753-0

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  • DOI: https://doi.org/10.1007/s00464-017-5753-0

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