Risk factors associated with multiple and missed gastric neoplastic lesions after endoscopic resection: prospective study at a single institution in south Korea.
OBJECTIVE
Only a small part of visible gas tric mucosal lesion can be removed by endoscopic resection. This study is aimed to identify incidence rate and associated risk factors of multiple and missed gastric lesions, and proper timing of follow-up en doscopy.


METHODS
Endoscopic surveillance was performed on 1 week, and 1, 6, 12 months af ter endoscopic resection. All multiple gastric lesions were divided into main and accessory lesions. The accessory lesions were subdivided into detected and missed lesions.


RESULTS
Totally, 250 lesions of 215 patients were analyzed. There were 81 early gastric cancers, 50 high grade dysplasias and 119 low grade dysplasias. Thirty patients (14%) had multiple gastric neoplastic lesions, either adenoma or cancer, within 1 year follow-up after endoscopic resection. Old age, male gender and severe intestinal metaplasia were independent risk factors of multiple gastric lesions. Small size (≤ 1 cm) and flat morphology were major risk factors of missed lesion. Among 10 missed lesions, 9 (90%) could be detected within 6 month after resection.


CONCLUSIONS
Old age, male gender, severe intestinal metaplasia were risk factors for multiple gastric lesions after endoscopic resection. Follow-up endoscopy is needed at least one time within six months after resection, with careful inspection of entire stomach.
Ji Sun
JS
Han
Jin Seok
JS
Jang
Hwan Cheol
HC
Ryu
Min Chan
MC
Kim
Ki Han
KH
Kim
Dong Kyun
DK
Kim
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D057210:Delayed Diagnosis; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D060787:Neoplasm Grading; D018365:Neoplasm, Residual; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome