Early detection of recurrence after endoscopic treatment for early gastric cancer.
OBJECTIVE
Although there have been many reports regarding clinical outcomes of endoscopic treatment for early gastric cancer (EGC), little is known about detection of recurrence after endoscopic submucosal dissection (ESD). This study aims to clarify the clinical value of serological marker or imaging tools, including conventional CT and PET-CT scans, in detecting recurrent gastric cancer after ESD in Korea.


METHODS
From July 2004 to March 2008, 212 patients who had received ESD for EGC were enrolled in the study. For preoperative staging, conventional CT and PET-CT scans were performed in 141 patients, and for detection of recurrence of cancer, conventional CT, PET-CT scans and tumour marker; CEA, CA19-9, AFP were checked in 165 patients.


RESULTS
The local recurrence rate was 4.7% (10/212) during the study period. At 9 months after endoscopic treatment, 3 cases recurred. Four showed recurrence at 12 months, 2 at 18 months and 1 at 24 months. The positive rate was 7.1% (10/141) in conventional CT and 0% (0/24) in PET-CT scans for preoperative staging. Conventional CT and PET-CT scans could not detect local recurrence of cancer during the follow-up period. Tumour markers did not show any significant correlation with recurrence of cancer.


CONCLUSIONS
The study suggests that conventional CT, PET-CT scans and tumour marker have no role in the primary surveillance of early gastric cancer and/or in detecting recurrence after endoscopic treatment. For early diagnosis of recurrence after endoscopic treatment, a biopsy specimen from the endoscopic examination has to be obtained at regular intervals.
Sohn
You Jung
YJ
Department of Internal Medicine, Dong-A Medical Center, University of College of Medicine, Busan, Korea.
Jang
Jin Seok
JS
Choi
Seok Reyol
SR
Kwon
Hyuk-Chan
HC
Jung
Ghap Joong
GJ
Kim
Min Chan
MC
Jeong
Jin Sook
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D005773:Gastroscopy; D006801:Humans; D007723:Korea; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000378:metabolism
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D000509:alpha-Fetoproteins