ANNUAL ENDOSCOPY IS ENOUGH FOR GASTRIC CANCER SURVEILLANCE SCHEDULE AFTER THE ENDOSCOPIC RESECTION

Aims Patients who received endoscopic resection for early gastric cancer (EGC) or high grade dysplasia (HGD) are at high risk of subsequent development of metachronous gastric cancer. The aim of this study is to compare the prognosis of patients between biannual and annual endoscopic surveillance in patients after endoscopic resection of EGC or HGD.

Methods From Sep 2009 to Aug 2019, a total of 826 patients who underwent endoscopic submucsal dissection for the treatment of EGC or HGD were analyzed. Patients received endoscopic surveillance twice a year (intensive group) or annually (annual group). Exclusion criteria were patients who received the surgical resection due to non-curative resection, endoscopic follow up period less than 5 years.

Results Total 388 patients were enrolled in this study (194 in intensive group and 194 annual group). During a mean follow-up of 5.7±1.5 years, local recurrence was found in six patients in intensive group and eight patient in annual group (3.1% and 4.1%, p=0.586). Metachronous gastric cancer in 20 patients (10.3%) in intensive group and 14 patients (7.2%) in annual group (p=0.281). Most stomach cancers of patients who received additional treatment including endoscopic or surgical resection were stage I EGC. Only one patient in intensive group was diagnosed as stage IIIA advanced gastric cancer.

Conclusions Annual endoscopic surveillance after endoscopic resection of EGC or HGD is more cost effective than biannual endoscopic examination.