Risk factors of recurrent and metachronous cancer of early gastric cancer after endoscopic resection
10.3760/cma.j.issn.1007-5232.2018.07.008
- VernacularTitle: 早期胃癌内镜下切除后复发及异时癌的影响因素探究
- Author:
Jian HUANG
1
;
Qingwei ZHANG
;
Xintian ZHANG
;
Ying ZHOU
;
Xiaobo LI
Author Information
1. Department of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine; Shanghai Institute of Digestive Disease, Shanghai 200001, China
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Neoplasm recurrence;
Risk factors;
Endoscopic resection;
Metachronous cancer
- From:
Chinese Journal of Digestive Endoscopy
2018;35(7):492-496
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the risk factors of recurrent and metachronous cancer of early gastric cancer (EGC) after endoscopic resection.
Methods:A retrospectively study was performed on the data of 309 patients (318 lesions) who underwent endoscopic mucosal resection or endoscopic submucosal dissection and were pathologically confirmed as EGC (including high-grade intraepithelial neoplasia) in the digestive endoscopy center of Shanghai Renji Hospital from October 2008 to December 2016. The risk factors of recurrent and metachronous cancer were analyzed using univariate and multivariate Cox regression analysis.
Results:The follow-up time ranged from 6 to 80 months, with median time of 26.6 months. Thirteen patients (4.2%, 13/309) had recurrence, and 8 (2.6%, 8/309) occurred metachronous cancer, and the total incidence rate of recurrent and metachronous cancer was 6.8% (21/309). The multivariate regression analysis showed that non-curative resection (P<0.01, HR=5.73, 95%CI: 1.75-18.74) was the independent risk factor of recurrence, and moderate to severe mucosa atrophy around the lesions before resection (P=0.04, HR=4.87, 95%CI: 1.10-21.50) was the independent risk factor of metachronous cancer of differentiated EGC after endoscopic resection.
Conclusion:Recurrent and metachronous cancer of EGC after endoscopic resection are rare but cannot be ignored. Patients with non-curative resection should be alert to postoperative recurrence, and differentiated EGC patients with moderate to severe mucosa atrophy around the lesions before resection should pay more attention to metachronous cancer.
