| Theme |
Best Available Managements of Helicobacter pylori Gastritis |
| Title |
Effects of Reducing Metachronous Gastric Cancer post Eradication of H. pylori Gastric Infection : From My Point of View (2) From the Aspect of Non-observed Lesion |
| Author |
Motohiko Kato |
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Osaka University |
| Author |
Tsutomu Nishida |
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Osaka University |
| Author |
Masahiko Tsujii |
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Osaka University |
| Author |
Tetsuo Takehara |
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Osaka University |
| [ Summary ] |
After endoscopic submucosal dissection (ESD) of early gastric cancer (EGC), patients are at high-risk for synchronous or metachronous multiple gastric cancer. Eradication therapy for H. pylori is widely applied in these cases. To elucidate the details of post ESD muliple cancer occurrence, we conducted a multicenter retrospective cohort study in 12 hospitals. Patients with EGC who underwent ESD with en bloc margin-negative curative resection were included. Synchronous cancer was classified as concomitant cancer or non-observed cancer. The cumulative incidence of metachronous cancers and overall survival rates were calculated using the Kaplan-Meier method. From April 1999 to December 2010, 1,258 patients met the inclusion criteria. Synchronous or metachronous multiple cancers were detected in 14.2 % of the patients. Of the 110 synchronous cancers observed, 21 were missed during initial ESD. The cumulative incidence of metachronous cancers increased linearly, and the mean annual incidence rate was 3.5 %. The incidence rate did not differ between patients having had H. pylori eradication or not. Approximately 20 % of synchronous cancers were not missed. Scheduled endoscopic surveillance is needed, especially during early post ESD phases irrespective of patients having received H. pylori eradication therapy or not. |