Risk Factors for Metachronous Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer.
Although endoscopic submucosal dissection (ESD) is widely accepted as a curative treatment method for early gastric cancer (EGC) worldwide, metachronous recurrence often occurs after ESD for EGC. However, there are insufficient data about the role of Helicobacter pylori (H. pylori) infection and other risk factors for recurrence. We aimed to compare the metachronous lesion in the H. pylori persistent group and the eradicated group, and to identify risk factors for metachronous lesion. We retrospectively analyzed 782 patients who underwent ESD between January 2008 and December 2013. We excluded patients with dysplasia or patients who were not tested for H. pylori infection. One hundred eighty-five patients were enrolled. We studied risk factors for recurrence, and used survival analysis to test. There were 24 patients with metachronous recurrence after ESD for EGC among the group. The incidence of metachronous gastric lesions after ESD for EGC developed more in the over 70-year-old group (P = 0.025) and more in the H. pylori persistent group (P = 0.008). In conclusion, H. pylori infection and old age are independent risk factors for metachronous gastric lesions after ESD in EGC.
Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
Chang Su
http://orcid.org/0000-0003-2278-4355
CS
Chung
Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
Hyun Sun
http://orcid.org/0000-0003-2388-9896
HS
Woo
Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea. drgreen@gilhospital.com.
Jun Won
http://orcid.org/0000-0002-0869-7661
JW
Chung
Division of Gastroenterology, Department of Internal Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon, Korea.
Seok Hoo
http://orcid.org/0000-0001-9197-1184
SH
Jeong
Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
Kwang An
http://orcid.org/0000-0002-2947-2111
KA
Kwon
Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
Yoon Jae
http://orcid.org/0000-0001-8477-6823
YJ
Kim
Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
Kyoung Oh
http://orcid.org/0000-0002-5365-2550
KO
Kim
Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
Dong Kyun
http://orcid.org/0000-0002-2862-6641
DK
Park
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000069916:Endoscopic Mucosal Resection; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology*
Endoscopic Submucosal Dissection; Gastric Cancer; Metachronous Recurrence