Individualized Endoscopic Surveillance for Metachronous Gastric Cancer After Endoscopic Submucosal Dissection: A...

Area of Science:

• Gastroenterology
• Oncology
• Endoscopic Surgery

Background:

• Endoscopic submucosal dissection (ESD) is standard for early gastric cancer and high-grade dysplasia.
• Metachronous gastric cancer (new cancers after initial treatment) is a significant concern post-ESD.
• Understanding recurrence patterns is crucial for effective patient management.

Purpose of the Study:

• To investigate the recurrence patterns of metachronous gastric cancer following ESD.
• To determine the correlation between metachronous gastric cancer and primary lesions.
• To identify optimal surveillance strategies based on primary lesion characteristics.

Main Methods:

• Retrospective review of 286 patients who underwent ESD for early gastric cancer or high-grade dysplasia.
• Definition of metachronous gastric cancer as new cancer detected >1 year post-ESD.
• Analysis of recurrence timing, incidence, and correlation with primary lesion location and pathology.

Main Results:

• 24 patients (8.4%) developed metachronous gastric cancer during a median 36-month follow-up.
• The 5-year cumulative incidence of metachronous gastric cancer was 13.4%.
• Recurrence showed significant correlation with primary lesion cross-sectional position, particularly between posterior walls and lesser curvatures.

Conclusions:

• Metachronous gastric cancer occurrence is associated with primary lesion location and timing.
• Individualized endoscopic surveillance, considering primary lesion characteristics, is recommended post-ESD.
• This approach can improve early detection and management of metachronous gastric cancer.