Clinical Implications of Synchronous and Metachronous Multiple Gastric Tumors after Endoscopic Resection of Gastric Neoplasms

Shin, Cheol Min

doi:10.5946/ce.2018.074

Cited by 1 publication

(1 citation statement)

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“…In addition, considering the pathogenesis of gastric adenoma and cancer, the minimal follow-up period, and the possible upgrade pathology from adenoma to carcinoma in the resected specimen, we excluded patients whose records included the code for gastric cancer or who died within 1 year of the index date. To ensure the adenoma cohort was accurately identified, we performed code validation study (26). In this study, positive predictive value for diagnosing gastric adenoma was more than 95% with codes from the International Classification of Diseases (ICD)-10 and claim code for endoscopic resection, which are shown in the Supplementary Digital Content (see Supplementary Table 2, http:// links.lww.com/AJG/D32).…”

Section: Patientsmentioning

confidence: 99%

Gastric Cancer Incidence and Mortality After Endoscopic Resection of Gastric Adenoma: A Nationwide Cohort Study

Park,

Cho,

Shin

et al. 2023

Am J Gastroenterol

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Objective: Gastric adenoma is a precursor lesion of gastric cancer. We investigated whether the removal of gastric adenoma prevented gastric cancer incidence and its mortality. Methods: Using the linkage of nation-wide databases, we assessed gastric cancer incidence and mortality among patients who had gastric adenomas removed between 2011 and 2013 in Korea. These outcomes were compared primarily with the Korean general population by estimating the standardized incidence and mortality ratio, and secondarily with internal control subjects who did not have gastric neoplasm after esophagogastroduodenoscopy and were matched for age, sex, and calendar year by calculating hazard ratios (HR) with the Cox proportional hazards model. Findings: We identified 44,405 adenoma-removal patients. During a median follow-up of 8.4 years, 1,038 (2.34%) of them were given a diagnosis of gastric cancer, and a total of 524 gastric cancers were expected, for a standard incidence ratio of 1.98 (95% CI, 1.84–2.13). A total of 199 deaths from gastric cancer were expected and 99 were observed, for a standard mortality ratio of 0.50 (95% CI, 0.40–0.60). Compared with the non-adenoma cohort (n=39,826), the adenoma-removal patients had a higher risk of gastric cancer (HR, 2.84; 95% CI, 2.51–3.21) and associated mortality (HR, 1.66; 95% CI, 1.19–2.31). Conclusions: Removal of gastric adenoma resulted in lower-than-expected mortality but higher-than-expected incidence due to gastric cancer than in the general population. Our analyses indicated the importance of the follow-up strategy after removal of gastric adenoma

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Section: Patientsmentioning

confidence: 99%