Follow-up after endoscopic resection for early gastric cancer in 3 French referral centers

Endoscopic resection is the recommended staging and treatment modality for early gastric cancer (EGC). However, in Europe, data on long-term treatment outcomes and the occurrence of metachronous gastric cancer are lacking.

Endoscopic resection for EGC was performed in 108 patients in 3 French referral centers. Resections were classified as eCuraA, B, C-1, or C-2 according to the new Japanese gastric cancer treatment guidelines and European guidelines. Patients who did not undergo secondary surgery and had follow-up data after 6 months were included in the analysis.

One hundred eight patients underwent endoscopic resection for EGC. Surgery was performed in 32 patients after endoscopic resection. Forty-five patients had follow-up visits at ≥6 months: 27 with an eCuraA resection, 1 with an eCuraB resection, 6 with an eCuraC-1 resection, and 11 with an eCuraC-2 resection. During a median follow-up time of 29.39 months, metachronous recurrence was observed in 12 patients (12/45; 26.7%) with a median period of 15.43 months (range, 7-44). Metastatic recurrence was observed in 3 patients (3/45, 6.7%), with a median period of 28.91 months (range, 7.52-28.91). Morbidity and mortality at day 30 after endoscopic resection were 2.8% (3/108) and 0.9% (1/108), respectively. Metachronous recurrences were diagnosed in 18.5% of the eCuraA group, 0% of the eCuraB group, 33.3% of the eCura C-1 group, and 45.5% of the eCura C-2 group; the differences were not statistically significant (P = .061).

The rate of metachronous recurrence after endoscopic resection of early gastric cancer was very high, even after a curative resection. Close endoscopic surveillance is necessary to diagnose and treat metachronous gastric cancer.