Surgical Endoscopy

, Volume 32, Issue 2, pp 846–854 | Cite as

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

  • Hyo-Joon Yang
  • Sang Gyun KimEmail author
  • Joo Hyun Lim
  • Ji Min Choi
  • Sooyeon Oh
  • Jae Yong Park
  • Seung Jun Han
  • Jung Kim
  • Hyunsoo Chung
  • Hyun Chae Jung



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.


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.


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%).


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.


Early gastric cancer Endoscopic submucosal dissection Surveillance Metachronous gastric cancer Young patients 



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

Compliance with ethical standards


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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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Hyo-Joon Yang
    • 1
  • Sang Gyun Kim
    • 2
    Email author
  • Joo Hyun Lim
    • 3
  • Ji Min Choi
    • 3
  • Sooyeon Oh
    • 2
  • Jae Yong Park
    • 2
  • Seung Jun Han
    • 2
  • Jung Kim
    • 2
  • Hyunsoo Chung
    • 2
  • Hyun Chae Jung
    • 2
  1. 1.Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
  2. 2.Division of Gastroenterology, Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulKorea
  3. 3.Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam CenterSeoul National University HospitalSeoulKorea

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