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Undifferentiated histology after endoscopic resection may predict synchronous and metachronous occurrence of early gastric cancer

 Seo J.H.  ;  Park J.C.  ;  Kim Y.J.  ;  Shin S.K.  ;  Lee Y.C.  ;  Lee S.K. 
 DIGESTION, Vol.81(1) : 35-42, 2010 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Signet Ring Cell/epidemiology ; Carcinoma, Signet Ring Cell/pathology ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Gastroscopy* ; Helicobacter Infections/complications ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Neoplasms, Second Primary/epidemiology ; Neoplasms, Second Primary/pathology ; Postoperative Period ; Predictive Value of Tests ; Retrospective Studies ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/microbiology ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery* ; Time Factors
Gastric cancer, early ; Endoscopic resection ; Synchronous cancer ; Metachronous cancer
BACKGROUND: Endoscopic resection (endoscopic mucosal resection, EMR, and endoscopic submucosal dissection, ESD) has been accepted worldwide as a less invasive standard treatment for early gastric cancer (EGC). However, the risk of synchronous and metachronous gastric cancer developing in the post-endoscopic resection patient has become a major problem. We investigated the incidence and characteristics of synchronous and metachronous multiple gastric cancers in a retrospective study of patients with EGC after endoscopic resection. PATIENTS AND METHODS: We studied the clinicopathological features of 235 patients with EGC who had undergone endoscopic resection and were periodically followed up using endoscopic examinations (181 with a single lesion, 34 synchronous multiple lesions, and 20 metachronous multiple lesions). RESULTS: The overall incidence of synchronous and metachronous multiple gastric cancer was 14.5 and 8.5%, respectively, during a follow-up of 12-77 (median 26.5) months. Undifferentiated histology of the primary lesion was related to the occurrence of synchronous gastric cancer (p < 0.001). Undifferentiated histology and upper location of the primary lesion were correlated with the occurrence of metachronous gastric cancer (p = 0.002, 0.001). Most synchronous and metachronous lesions were well to moderately differentiated (82.4 and 80.0%); however, the proportion with undifferentiated histology (including poorly differentiated carcinoma and signet ring cell carcinoma) in synchronous and metachronous gastric cancer was significantly higher than in single gastric cancer (p = 0.008). CONCLUSIONS: Undifferentiated histology of EGC may predict the occurrence of synchronous and metachronous lesions after endoscopic resection.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yoo Jin(김유진)
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Seo, Ju Hee(서주희)
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
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