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Comparison of biannual and annual endoscopic gastric cancer surveillance after endoscopic resection

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Abstract

Background

Patients who received endoscopic resection (ER) for early gastric cancer (EGC) or high-grade dysplasia (HGD) are at high risk for the subsequent development of metachronous gastric cancer (MGC). This study aims to compare the detection rate and stage of MGC between biannual and annual endoscopic surveillance after ER of EGC or HGD.

Methods

From September 2009 to August 2019, 859 patients who underwent ER for the treatment of EGC or HGD were analyzed, retrospectively. Patients received endoscopic surveillance twice a year (high-intensity group) or annually (low-intensity group) for 3 years.

Results

A total of 521 patients were enrolled in this study (267 patients in the high-intensity group and 254 patients in the low-intensity group). During a mean follow-up of 5.3 ± 1.6 years, MGCs were found in 27 patients (16.9%) in the high-intensity group and 18 patients (7.1%) in the low-intensity group (P = 0.219). In patients with moderate to severe atrophy (Kimura–Takemoto grade C3 ~ O3), detection rates of MGC during 3 years from were 8.4% (16/191) and 2.2% (4/186), respectively (P = 0.007). Forty-four patients who received treatment for MGC, including endoscopic or surgical resection, were stage IA. Only one patient in the low-intensity group was diagnosed as stage IIIA advanced gastric cancer.

Conclusions

There was no significant difference in the detection rate of MGC between biannual and annual endoscopic surveillance after ER of EGC or HGD. However, biannual surveillance showed a higher detection rate during the first 3 years, especially for patients with moderate to severe gastric atrophy.

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Acknowledgement

The authors would like to thank Editage (www.editage.co.kr) for English language editing.

Funding

This work was partly supported by the Korean College of Helicobacter and Upper Gastrointestinal Research Foundation Grant (KCHUGR–202001003).

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Authors and Affiliations

  1. Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Gyeongsangnam-do, Yangsan-si, 50612, Korea

    Su Jin Kim, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim & Su Bum Park

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  1. Su Jin Kim
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Dae Hwan Kang, Hyung Wook Kim, and Su Bum Park. The first draft of the manuscript was written by Su Jin Kim, and Cheol Woong Choi reviewed and edited this manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Cheol Woong Choi.

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Disclosures

Su Jin Kim, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Hyeong Seok Nam, and Dae Gon Ryu have no conflicts of interest or financial ties to disclose.

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Kim, S.J., Choi, C.W., Kang, D.H. et al. Comparison of biannual and annual endoscopic gastric cancer surveillance after endoscopic resection. Surg Endosc 36, 1806–1813 (2022). https://doi.org/10.1007/s00464-021-08460-8

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