[Gastric polyps: prognosis and treatment]

Area of Science:

• Gastroenterology
• Oncology
• Surgical Pathology

Background:

• Epithelial gastric polyps are common findings during gastrointestinal examinations.
• The long-term risk of malignant transformation in gastric polyps remains a significant clinical concern.
• Previous treatments for gastric polyps included resection or excision, necessitating long-term follow-up.

Purpose of the Study:

• To evaluate the long-term outcomes of patients treated for epithelial gastric polyps.
• To determine the incidence of gastric carcinoma in patients with a history of gastric polyps.
• To establish optimal management strategies for different types of gastric polyps.

Main Methods:

• Retrospective analysis of 49 patients previously treated for epithelial gastric polyps.
• Long-term follow-up examinations, including endoscopy and radiological assessments, up to 22 years post-treatment.
• Histopathological examination of resected polyps and surgically removed gastric tissue.

Main Results:

• Gastric carcinoma was histologically confirmed in 5 patients and probable in 1 patient among the follow-up cohort.
• Three asymptomatic gastric carcinomas were detected during endoscopic surveillance, with two treated surgically (early gastric cancer) and one inoperable.
• Patients with gastric polyps demonstrated an elevated risk of developing gastric carcinoma.

Conclusions:

• Epithelial gastric polyps necessitate endoscopic or operative removal and thorough histological evaluation; observation alone is insufficient.
• Management strategies vary based on polyp type: local removal for hyperplastic polyps, two-third resection for pure adenomas, and polypectomy for solitary hyperplasiogenic polyps.
• Annual endoscopic surveillance is recommended for all patients with gastric polyps due to the increased risk of gastric carcinoma, irrespective of symptoms.