Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer: a multicentre retrospective cohort study by Osaka University ESD study group

Kato, Motohiko; Nishida, Tsutomu; Yamamoto, Katsumi; Hayashi, Shiro; Kitamura, Shinji; Yabuta, Takamasa; Yoshio, Toshiyuki; Nakamura, Takeshi; Komori, Masato; Kawai, Naoki; Nishihara, Akihiro; Nakanishi, Fumihiko; Nakahara, Masanori; Ogiyama, Hideharu; Kinoshita, Kazuo; Yamada, Takuya; Iijima, Hideki; Tsujii, Masahiko; Takehara, Tetsuo

doi:10.1136/gutjnl-2011-301647

Cited by 234 publications

(233 citation statements)

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“…Several studies have reported annual incidences of MGC after H. pylori eradication, ranging from 0.1 to 0.5 % in healthy individuals or peptic ulcer patients [26][27][28][29][30][31][32][33], and from 0.8 to 4.1 % in patients after endoscopic resection for early gastric cancer [9,[11][12][13][14][15]. Individuals after endoscopic resection had a higher risk of MGC compared with those who were healthy or had peptic ulcers.…”

Section: Discussionmentioning

confidence: 99%

“…A previous multicenter prospective randomized study performed in Japan showed that eradication of Helicobacter pylori reduced the incidence of MGC after endoscopic resection for early gastric cancer [11]. However, MGC sometimes develops even after successful H. pylori eradication, with an annual incidence of 0.8-4.1 % [9][10][11][12][13][14][15]. In most previous studies, only incidences of MGC within a 3-year median follow-up period were reported, and a study with a longer follow-up period is needed.…”

Section: Introductionmentioning

confidence: 99%

“…However, the development of metachronous gastric cancer (MGC), owing to the preservation of the entire stomach after endoscopic resection, remains a possibility [8][9][10]. A previous multicenter prospective randomized study performed in Japan showed that eradication of Helicobacter pylori reduced the incidence of MGC after endoscopic resection for early gastric cancer [11].…”

Section: Introductionmentioning

confidence: 99%

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Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan

Mori

Nakajima

Asada³

et al. 2015

Gastric Cancer

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Background A previous multicenter prospective randomized study from Japan showed that Helicobacter pylori eradication reduced the development of metachronous gastric cancer (MGC) after endoscopic resection for early gastric cancer. MGC risk, however, is not eliminated; yet few studies have evaluated its long-term incidence and risk factors. In this study, we investigated the incidence of and risk factors for MGC in patients who underwent endoscopic resection for early gastric cancer with successful H. pylori eradication. Methods A total of 594 patients who underwent endoscopic resection for early gastric cancer and successful H. pylori eradication at three institutions (National Cancer Center Hospital, University of Tokyo Hospital, and Wakayama Medical University Hospital) were analyzed retrospectively. Annual endoscopic surveillance was performed after initial endoscopic resection. MGC was defined as a gastric cancer newly detected at least 1 year after successful H. pylori eradication. Results Ninety-four MGCs were detected in 79 patients during the 4.5-year median follow-up period. KaplanMeier analysis showed the cumulative incidence of MGC 5 years after successful H. pylori eradication was 15.0 %; the incidence of MGC calculated by use of the person-year method was 29.9 cases per 1000 person-years. Multivariate analysis using the Cox proportional hazards model revealed that male sex, severe gastric mucosal atrophy, and multiple gastric cancers before successful H. pylori eradication were independent risk factors for MGC. Eleven percent of MGCs (10 of 94) were detected more than 5 years after successful H. pylori eradication. Conclusion Surveillance endoscopy for MGC in patients who have undergone endoscopic resection for early gastric cancer should be performed even after successful H. pylori eradication.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan

Mori

Nakajima

Asada³

et al. 2015

Gastric Cancer

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“…6 Kato et al reported that synchronous early gastric cancer had a prevalence of approximately 9%. 24 One possible reason for the risk of synchronous lesions is the endoscopist's lack of experience. Therefore, careful preoperative examination by an experienced endoscopist is needed.…”

Section: Elderly Patients N=130mentioning

confidence: 99%

Efficacy and safety of endoscopic submucosal dissection for elderly patients with superficial squamous esophageal neoplasms

Peng

Shen

et al. 2016

UEG Journal

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Background: Little is known about the outcomes of endoscopic submucosal dissection in elderly patients with superficial squamous esophageal neoplasms. Objective: To assess the efficacy and safety of endoscopic submucosal dissection for superficial squamous esophageal neoplasms in elderly patients (!65 years) compared with non-elderly patients. Methods: All patients with superficial squamous esophageal neoplasms receiving endoscopic submucosal dissection were retrospectively analyzed. Among them, 130 were aged 65 or older (group A), and 201 were aged younger than 65 years (group B). Therapeutic efficacy, adverse events, and follow-up data were evaluated. Results: Group A had a higher prevalence of concomitant diseases than group B (52.3% vs. 14.9%, respectively). R0 resection rate was 82.3% in group A and 84.6 % in group B (P ¼ 0.717). The curative resection rate was 80.8% in group A and 83.6% in group B (P ¼ 0.653). The rate of procedure-related non-cardiopulmonary adverse events was 20.8% in group A and 16.9% in group B (P ¼ 0.377). The incidence of cardiopulmonary adverse events during or after the procedure was 6.2% in group A and 2.5% in group B (P ¼ 0.094). No procedure-related mortality was reported in either group. Conclusion: Endoscopic submucosal dissection is effective and safe for treating superficial squamous esophageal neoplasms in elderly patients.

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“…A multicentre retrospective cohort study from 12 hospitals aimed at elucidating the time at which multiple GCs develop and determining whether scheduled endoscopic surveillance might control their development [13]; 1258 Japanese patients with early GC (EGC) who underwent endoscopic submucosa dissection (ESD) with en bloc margin-negative curative resection from April 1999 to December 2010 were included. Synchronous cancer was classified as concomitant cancer or missed cancer.…”

Section: Gastric Cancer: Secondary Preventionmentioning

confidence: 99%

Gastric Cancer—Epidemiologic and Clinical Aspects

Venerito

Nardone²,

Selgrad

et al. 2014

Helicobacter

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Gastric cancer (GC) continues to be an important health threat as the third leading cause of cancer related death in both sexes worldwide. In a recent analysis, the mortality trends for the time period from 1980 till 2011 were significantly downward in all countries, but the declines in the USA, EU and several other major countries were of low magnitude when compared with the past. Furthermore, the relative contribution of cardia cancers compared with noncardia cancers increased among countries with higher GC rates. With respect to preneoplastic changes of the gastric mucosa, a large population-based study suggests that Helicobacter pylori infection and antigastric parietal cell antibodies-mediated autoimmune response might, for the most part, be independent and follow distinct pathways rather than causally related pathways leading to chronic atrophic gastritis. A large prospective, randomized, open-label Korean trial questioned the role of H. pylori eradication for the prevention of metachronous lesions after endoscopic resection of early GC. A review of 1258 Japanese cases undergoing curative endoscopic submucosa dissection for early GC showed that scheduled follow-up endoscopy is mandatory for detecting metachronous lesions at an early stage, where they can be treated by endoscopic resection. Ramucirumab, a vascular endothelial growth factor receptor-2 antagonist, is the first biological treatment that provides survival benefits to patients with advanced GC in progress after first-line chemotherapy. The target agent rilotumumab is currently being evaluated in patients with advanced GC overexpressing the HGF/c-MET signaling pathway. In the near future, ipilimumab and nivolumab, two immunostimulatory monoclonal antibodies with antineoplastic effects, might offer new therapeutic options for patients with advanced GC.In 2014, Helicobacter pylori infection is still one of the world's most prevalent infections and continues to represent the major risk factor for gastric cancer (GC), which accounts annually for at least 738,000 deaths Gastric Cancer: Epidemiologic Aspects GC remains the third leading cause of death from cancer worldwide, following lung and liver cancer [2]. A declining incidence of GC has been registered over the past sixty years. However, recent epidemiologic data show that the incidence of noncardia GC in younger age groups (<50 years) remains constant or is even on the rise again in the United States since 1977, whereas

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Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer: a multicentre retrospective cohort study by Osaka University ESD study group

Abstract: Nineteen per cent of synchronous cancers were not detected until the initial ESD. The incidence rate of metachronous cancer after ESD was constant. Scheduled endoscopic surveillance showed that almost all recurrent lesions were treatable by endoscopic resection.

Cited by 234 publications

References 21 publications

Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan

Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan

Efficacy and safety of endoscopic submucosal dissection for elderly patients with superficial squamous esophageal neoplasms

Gastric Cancer—Epidemiologic and Clinical Aspects

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