Risk Factors for Developing Metachronous Superficial Gastric Epithelial Neoplasms after Endoscopic Submucosal...

Area of Science:

• Gastroenterology
• Oncology
• Endoscopy

Background:

• Endoscopic submucosal dissection (ESD) offers curative resection for gastric neoplasms but leaves patients susceptible to metachronous superficial gastric epithelial neoplasms (MSGENs).
• Identifying risk factors for MSGENs post-ESD is crucial for patient management and surveillance strategies.

Purpose of the Study:

• To identify clinicopathological risk factors associated with the development of MSGENs after ESD.
• To evaluate the potential association between Helicobacter pylori (H. pylori) status and MSGEN occurrence.

Main Methods:

• A retrospective cohort study was conducted involving 369 patients with 382 lesions treated with ESD for adenoma or early gastric cancer.
• Patients were categorized into MSGEN and not-MSGEN groups to compare clinicopathological characteristics and H. pylori status.

Main Results:

• Twenty-seven MSGENs were identified. The MSGEN group showed a higher frequency of histological intestinal metaplasia (HIM) and initial neoplasm in the upper/middle stomach (INUM).
• HIM and INUM were associated with a significantly higher cumulative incidence of MSGENs.
• A higher frequency of spontaneous H. pylori disappearance was observed in the MSGEN group compared to the control group.

Conclusions:

• Histological intestinal metaplasia (HIM), upper/middle gastric neoplasm location (INUM), and spontaneous H. pylori eradication are potential clinicopathological risk factors for MSGENs following ESD.
• These findings may inform targeted surveillance and prevention strategies for patients undergoing ESD.