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Risk Factors for Metachronous Recurrence after Endoscopic Submucosal Dissection of a Gastric Neoplasm

 ( Choe A-Reum ) - Ewha Womans University School of Medicine Department of Internal Medicine

 ( Shim Ki-Nam ) - Ewha Womans University School of Medicine Department of Internal Medicine
 ( Kim Tae-Oh ) - Ewha Womans University School of Medicine Department of Internal Medicine
 ( Kim Sang-Yoon ) - Ewha Womans University School of Medicine Department of Internal Medicine
 ( Lim Ji-Young ) - Ewha Womans University School of Medicine Department of Internal Medicine
 ( Tae Chung-Hyun ) - Ewha Womans University School of Medicine Department of Internal Medicine
 ( Moon Chang-Mo ) - Ewha Womans University School of Medicine Department of Internal Medicine
 ( Kim Seong-Eun ) - Ewha Womans University School of Medicine Department of Internal Medicine
정혜경 ( Jung Hye-Kyung ) - Ewha Womans University School of Medicine Department of Internal Medicine
 ( Jung Sung-Ae ) - Ewha Womans University School of Medicine Department of Internal Medicine

Abstract


Background/Aims: Although endoscopic submucosal dissection (ESD) is an accepted treatment method for gastric neoplasm worldwide, metachronous recurrence often occurs. Here, we evaluated the risk factors for metachronous recurrence after ESD of gastric dysplasia or adenocarcinoma and also examined the effects of Helicobacter pylori (H. pylori) eradication.

Materials and Methods: Among 400 patients who underwent endoscopic resection from February 2005 to December 2014 at Ewha Womans University Hospital, the medical records of 180 patients were retrospectively reviewed.

Results: The enrolled patients included 118 men and 62 women, and their median age was 61.7±10.3 years. During a median follow-up period of 34.5 months, metachronous recurrence occurred in 21 (11.7%) patients. Multivariate analyses revealed that H. pylori eradication did not have any preventive effects on metachronous recurrence. A family history of gastric cancer was the only risk factor for metachronous recurrence after ESD of the gastric neoplasm.

Conclusions: Metachronous recurrence was found to be related to family history of gastric cancer. However, H. pylori eradication had no preventive effects on metachronous recurrence after ESD of a gastric neoplasm. Therefore, intensive surveillance is required for patients who undergo ESD of a gastric neoplasm and have a family history of gastric cancer.

키워드

Endoscopic submucosal dissection; Metachronous recurrence; Stomach neoplasms
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