Open AccessLong-term outcomes of patients with gastric adenoma in Korea
Author(s) -
Tae Young Park,
Su Jin Jeong,
Tae Hyung Kim,
Jin Liu,
Jongha Park,
Tae Oh Kim,
Yongeun Park
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000019553
Subject(s) - medicine , hazard ratio , confidence interval , adenoma , intestinal metaplasia , lesion , biopsy , gastroenterology , pathological , endoscopy , surgery , endoscopic mucosal resection , stomach
New endoscopic resection techniques are constantly being developed for gastric adenoma, which can be classified as low or high grade according to the Vienna classification. However, long-term data on gastric adenoma (e.g., removal or follow-up after resection via endoscopy) remain lacking. We retrospectively analyzed 133 cases with gastric adenoma that underwent endoscopic resection from January 2010 to November 2018. We analyzed the risk factors and frequency of patients with synchronous and metachronous lesions after endoscopic resection for gastric adenoma and followed them for more than 2 years. One hundred six (79.7%) and 27 patients (20.3%) received endoscopic resection (ER) once and more than twice, respectively. Compared with the initial endoscopic biopsy pathological results, the upgraded and downgraded histological discrepancy rates were 10.5% (n = 14) and 3.0% (n = 4) after resection, respectively. The mean time to synchronous/metachronous recurrence was 2.23 years. The average lesion size at first procedure was larger in the multiple ER group than in the single ER group (2.00 vs 1.10 cm; P = .040). Eleven (8.3%) and 16 patients (12.0%) had recurred synchronous and metachronous lesions, respectively. In the multivariate Cox analysis of the recurrence group, intestinal metaplasia (hazard ratio, 2.761; 95% confidence interval, 1.117–6.820; P = .028) and lesion size (hazard ratio, 1.607; 95% confidence interval, 1.082–2.385; P = .019) were independent factors for receiving endoscopic resection more than twice. If patients have severe intestinal metaplasia or large size of lesion at endoscopic resection for gastric adenoma, periodic observation is necessary.