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The optimal interval of surveillance gastroscopy after endoscopic resection for gastric neoplasia: a multicenter cohort study

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Abstract

Background/aims

Due to the possible metachronous recurrence of gastric neoplasia, surveillance gastroscopy is mandatory after endoscopic resection for gastric neoplasia. However, there is no consensus on the surveillance gastroscopy interval. This study aimed to find an optimal interval of surveillance gastroscopy and to investigate the risk factors for metachronous gastric neoplasia.

Methods

Medical records were reviewed retrospectively in patients who underwent endoscopic resection for gastric neoplasia in 3 teaching hospitals from June 2012 to July 2022. Patients were divided into two groups; annual surveillance vs. biannual surveillance. The incidence of metachronous gastric neoplasia was identified, and the risk factors for metachronous gastric neoplasia were investigated.

Results

Among the 1,533 patients who underwent endoscopic resection for gastric neoplasia, 677 patients were enrolled in this study (annual surveillance 302, biannual surveillance 375). Metachronous gastric neoplasia was observed in 61 patients (annual surveillance 26/302, biannual surveillance 32/375, P = 0.989), and metachronous gastric adenocarcinoma was observed in 26 patients (annual surveillance 13/302, biannual surveillance 13/375, P = 0.582). All the lesions were removed by endoscopic resection successfully. In a multivariate analysis, severe atrophic gastritis on gastroscopy was an independent risk factor for metachronous gastric adenocarcinoma (odds ratio 3.8, 95% confidence interval 1.4‒10.1; P = 0.008).

Conclusions

Meticulous observation to detect the metachronous gastric neoplasia is necessary for patients with severe atrophic gastritis during follow-up gastroscopy after endoscopic resection for gastric neoplasia. Annual surveillance gastroscopy might be enough after endoscopic resection for gastric neoplasia.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Younghee Choe, Byung-Wook Kim, Jongwon Kim, Soo-Young Na & Joon Sung Kim

  2. Division of Gastroenterology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Tae Ho Kim

  3. Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea

    Jun-Won Chung

  4. The Catholic University of Korea, 56, Dongsu-ro, Bupyeong-gu, Incheon, 21431, Republic of Korea

    Byung-Wook Kim

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  1. Younghee Choe
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Correspondence to Byung-Wook Kim.

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Dr. Younghee Choe, Dr. Byung-Wook Kim, Dr. Tae Ho Kim, Dr. Jun-Won Chung, Dr. Jongwon Kim, Dr. Soo-Young Na, and Dr. Joon Sung Kim have no conflict of interest or financial ties to disclose.

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Choe, Y., Kim, BW., Kim, T.H. et al. The optimal interval of surveillance gastroscopy after endoscopic resection for gastric neoplasia: a multicenter cohort study. Surg Endosc 37, 7556–7562 (2023). https://doi.org/10.1007/s00464-023-10259-8

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  • DOI: https://doi.org/10.1007/s00464-023-10259-8

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