Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Risk factors for developing metachronous superficial gastric epithelial neoplasms after endoscopic submucosal dissection

Version 1 : Received: 18 October 2023 / Approved: 19 October 2023 / Online: 19 October 2023 (10:45:59 CEST)

A peer-reviewed article of this Preprint also exists.

Suzuki, T.; Goda, K.; Ishikawa, M.; Yamaguchi, S.; Yoshinaga, T.; Kondo, M.; Kanazawa, M.; Kunogi, Y.; Tanaka, T.; Kanamori, A.; et al. Risk Factors for Developing Metachronous Superficial Gastric Epithelial Neoplasms after Endoscopic Submucosal Dissection. Journal of Clinical Medicine 2024, 13, 1587, doi:10.3390/jcm13061587. Suzuki, T.; Goda, K.; Ishikawa, M.; Yamaguchi, S.; Yoshinaga, T.; Kondo, M.; Kanazawa, M.; Kunogi, Y.; Tanaka, T.; Kanamori, A.; et al. Risk Factors for Developing Metachronous Superficial Gastric Epithelial Neoplasms after Endoscopic Submucosal Dissection. Journal of Clinical Medicine 2024, 13, 1587, doi:10.3390/jcm13061587.

Abstract

Background: Although endoscopic submucosal dissection (ESD) can provide a high rate of curative resection, remaining gastric mucosa after ESD is at risk of metachronous recurrence. We investigated risk factors for metachronous superficial gastric epithelial neoplasms (MSGENs) following ESD. Methods: We conducted a retrospective cohort study including 369 patients with 382 lesions that underwent ESD for adenoma/early gastric cancer. The primary endpoint was to identify clinicopathological risk factors for the occurrence of MSGENs. The secondary endpoint was to evaluate the association of Helicobacter pylori (Hp) eradication with the MSGENs. Results: Twenty-seven MSGENs were occurred. The subjects were divided into MSGEN and not-MSGEN groups. There was a significantly higher frequency of histological intestinal metaplasia (HIM) and initial neoplasm location in upper or middle part (INUM) in the MSGEN group. The HIM group and INUM group had significantly higher cumulative incidence of MSGENs. We compared the 27 patients of MSGEN group and 27 patients of matched not-MSGEN (Mnot-MSGEN) group that was matched to the MSGEN group for variables including HIM and INUM. There was a significantly higher frequency of Hp spontaneous eradication in the MSGEN group. Conclusion: HIM, INUM and Hp spontaneous eradication may be clinicopathological risk factors for developing MSGENs after ESD.

Keywords

stomach; early gastric cancer; gastric adenoma; metachronous cancer; cumulative incidence; en-doscopic resection; endoscopic submucosal dissection; Helicobacter pylori; spontaneous eradica-tion; intestinal metaplasia

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

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