Clinical impact of colonoscopy for patients with early gastric cancer treated by endoscopic submucosal dissection: A matched case-control study.
BACKGROUND
Gastric cancer frequently occurs synchronously with colorectal cancer (CRC).


OBJECTIVE
The aim of the present study was to assess the value of colonoscopy in patients with primariy early gastric cancer (EGC) indicated for endoscopic submucosal dissection (ESD) and to identify predictors for the risk of high-risk adenomas.


METHODS
A total of 130 patients with EGC, who underwent both colonoscopy and gastric ESD, and 260 controls matched for age and sex, who underwent a colonoscopy as part of our institutional health check-up program. The prevalence of high-risk adenomas in EGC patients vs. controls was evaluated.


RESULTS
High-risk adenomas were found in 43 (33%) EGC patients and 37 (14%) controls (P<0.01). Multivariate analysis showed the presence of EGC was significantly associated with high-risk adenoma [odds ratio (OR) 2.8, 95% confidence interval (CI): 1.7-4.9]. Among EGC patients, high serum CEA level (OR 2.4, 95% CI: 1.2-5.0) was an independent predictor for high-risk adenoma.


CONCLUSIONS
Patients with EGC had a significant risk for colorectal cancer. When endoscopists detected an early gastric cancer indicated for ESD, colonoscopy should be considered for EGC patients with high serum CEA levels.
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan. Electronic address: k.imai1977@gmail.com.
Kenichiro
K
Imai
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Kinichi
K
Hotta
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Yuichiro
Y
Yamaguchi
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Noboru
N
Kawata
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Naomi
N
Kakushima
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Masaki
M
Tanaka
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Kohei
K
Takizawa
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Hiroyuki
H
Matsubayashi
Division of Pathology, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Tadakazu
T
Shimoda
Clinical Trial Coordination Office, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Keita
K
Mori
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho, Suntogun, Shizuoka, Japan.
Hiroyuki
H
Ono
D000236:Adenoma / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D000069916:Endoscopic Mucosal Resection; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications* / Q000601:surgery*
D002272:Carcinoembryonic Antigen
Colon cancer; Colonoscopy; Endoscopic submucosal dissection; Gastric cancer; Helicobacter pylori