| Theme |
Precancerous Conditions and Cancer High-risk Lesions in the Esophagus and the Stomach |
| Title |
Metachronous Gastric Cancer after Endoscopic Resection and Surgical Resection |
| Author |
Mototsugu Kato |
Division of Endoscopy, Hokkaido University Hospital |
| Author |
Shouko Ono |
Division of Endoscopy, Hokkaido University Hospital |
| Author |
Yuichi Shimizu |
Department of Gastroenterology, Hokkaido University Graduate School of Medicine |
| Author |
Masahiro Asaka |
Department of Gastroenterology, Hokkaido University Graduate School of Medicine |
| [ Summary ] |
Since the vast majority of gastric cancers develop from a background of H. pylori infection of the gastric mucosa, H. pylori plays an important role in gastric carcinogenesis. The treatment of gastric cancer is divided into the fields of nonsurgical and surgical treatment. The development of endoscopic submucosal dissection expanded the indications for endoscopic treatment of early gastric cancer. Most residual cancers due to incomplete resection occur within two years of endoscopic treatment. Metachronous gastric cancers are common, and continue to occur long after endoscopic treatment for primary cancer. A multi-center, randomized controlled trial in Japan reported that H. pylori eradication significantly reduced the incidence of metachronous gastric cancer after endoscopic resection. H. pylori eradication is projected to prevent the development of gastric cancer. The frequency of remnant stomach cancers is not high. The risk of gastric remnant cancer is associated with intragastric circumstances after surgical resection such as reflux of duodenal juice and vagotomy. |