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Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE
Yong Chan Lee |
Professor of Medicine Director, Gastrointestinal Research Laboratory Veterans Affairs Medical Center, Univ. California San Francisco San Francisco, USA |
Jong Pil Im | Seoul National University College of Medicine, Seoul, Korea |
Robert S. Bresalier | University of Texas M. D. Anderson Cancer Center, Houston, USA |
Steven H. Itzkowitz | Mount Sinai Medical Center, NY, USA |
All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.
The final responsibility for the decision to accept or reject lies with the editors. In many cases, papers may be rejected despite favorable reviews because of editorial policy or a lack of space. The editor retains the right to determine publication priorities, the style of the paper, and to request, if necessary, that the material submitted be shortened for publication.
Correspondence to: Gwang Ha Kim
Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
Tel: +82-51-240-7869, Fax: +82-51-244-8180, E-mail: doc0224@pusan.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gut Liver 2020;14(2):145-147. https://doi.org/10.5009/gnl20018
Published online March 15, 2020, Published date March 15, 2020
Copyright © Gut and Liver.
Endoscopic submucosal dissection (ESD) has been widely used as a curative treatment for early gastric cancers (EGCs). ESD has historically high en bloc and curative resection rates for EGCs, regardless of their size and location. ESD is a minimal invasive procedure compared to surgical gastrectomy, and is an advantageous approach due to preservation of the entire stomach. Despite these advantages, there is a concerning rate of newly developed gastric cancers in the preserved stomach after ESD. Metachronous gastric cancer (MGC) is defined as a newly developed gastric cancer occurring at a previously uninvolved site 1 year or more after index ESD.
In this issue of
Risk factors associated with development of MGC include male sex, old age, current smoking, severe atrophy, intestinal metaplasia, persistent
Because gastric atrophy progresses from the antrum to the lower body, MGC is usually located at the lower third of the stomach and appears as a small, differentiated-type intramucosal cancer <20 mm in size.6,11 Most patients with MGC already have marked atrophy and intestinal metaplasia in the background gastric mucosa. Because
The incidence of MGC following ESD for EGCs has been reported to be 3.3% to 15.6%, according to the follow-up duration (Table 1). The mean annual incidence of MGC after ESD is approximately 2.5% to 3.5% and linearly increases;11 a 10-year cumulative incidence of MGC may increase up to 22.7%.2 Thus, clinicians should perform annual surveillance endoscopy for at least 10 years after ESD, paying special attention to the lower third of the stomach.
MGC can be treated similarly to an initial EGC. Because MGC is usually a small, differentiated-type, mucosal cancer, it can be treated by ESD. Long-term treatment outcomes of ESD for MGC are excellent when curative resection is achieved. Previous studies have reported that curative resection rates for MGC are 89% to 99%, and the 5-year and 10-year disease-specific survival rates in patients with MGC after curative ESD are 99% and 93%, respectively.2,4,6 Surgical treatment is necessary for MGC with beyond the extended criteria of ESD for EGCs.
In summary, patients who have undergone ESD for EGCs experiences a high incidence of MGC that increases linearly for at least 10 years. Although
No potential conflict of interest relevant to this article was reported.
Incidence and Risk Factors of Metachronous Gastric Cancers Occurring after Endoscopic Resection for Early Gastric Cancers
Study (year) | Subject no. | Mean follow-up period (yr) | Incidence of metachronous cancer (%) | Risk factors |
---|---|---|---|---|
Abe |
1,526 | 6.8 | 15.6 | Multiple initial cancers |
Male sex | ||||
Sugimoto |
155 | 4.2 | 14.8 | Intestinal metaplasia |
Neutrophil infiltration | ||||
Mori |
594 | 4.5 | 13.3 | Male sex |
Severe atrophy | ||||
Multiple initial cancers | ||||
Ami |
539 | 8.7 | 13.0 | Old age (>60 yr) |
Current smoking | ||||
Cho |
2,334 | 3.5 | 3.3 | Aging |
Chung |
185 | 5.6 | 13.0 | Old age (>70 yr) |
Persistent Helicobacter pylori infection | ||||
Kwon |
590 | 4.0 | 10.8 | Persistent H. pylori infection |
Serum pepsinogen I/II ratio ≤3 | ||||
Okada |
384 | 4.1 | 15.6 | Aging |
Differentiated-type histology | ||||
Multiple initial cancers |
Gut and Liver 2020; 14(2): 145-147
Published online March 15, 2020 https://doi.org/10.5009/gnl20018
Copyright © Gut and Liver.
Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
Correspondence to:Gwang Ha Kim
Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
Tel: +82-51-240-7869, Fax: +82-51-244-8180, E-mail: doc0224@pusan.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Endoscopic submucosal dissection (ESD) has been widely used as a curative treatment for early gastric cancers (EGCs). ESD has historically high en bloc and curative resection rates for EGCs, regardless of their size and location. ESD is a minimal invasive procedure compared to surgical gastrectomy, and is an advantageous approach due to preservation of the entire stomach. Despite these advantages, there is a concerning rate of newly developed gastric cancers in the preserved stomach after ESD. Metachronous gastric cancer (MGC) is defined as a newly developed gastric cancer occurring at a previously uninvolved site 1 year or more after index ESD.
In this issue of
Risk factors associated with development of MGC include male sex, old age, current smoking, severe atrophy, intestinal metaplasia, persistent
Because gastric atrophy progresses from the antrum to the lower body, MGC is usually located at the lower third of the stomach and appears as a small, differentiated-type intramucosal cancer <20 mm in size.6,11 Most patients with MGC already have marked atrophy and intestinal metaplasia in the background gastric mucosa. Because
The incidence of MGC following ESD for EGCs has been reported to be 3.3% to 15.6%, according to the follow-up duration (Table 1). The mean annual incidence of MGC after ESD is approximately 2.5% to 3.5% and linearly increases;11 a 10-year cumulative incidence of MGC may increase up to 22.7%.2 Thus, clinicians should perform annual surveillance endoscopy for at least 10 years after ESD, paying special attention to the lower third of the stomach.
MGC can be treated similarly to an initial EGC. Because MGC is usually a small, differentiated-type, mucosal cancer, it can be treated by ESD. Long-term treatment outcomes of ESD for MGC are excellent when curative resection is achieved. Previous studies have reported that curative resection rates for MGC are 89% to 99%, and the 5-year and 10-year disease-specific survival rates in patients with MGC after curative ESD are 99% and 93%, respectively.2,4,6 Surgical treatment is necessary for MGC with beyond the extended criteria of ESD for EGCs.
In summary, patients who have undergone ESD for EGCs experiences a high incidence of MGC that increases linearly for at least 10 years. Although
No potential conflict of interest relevant to this article was reported.
Incidence and Risk Factors of Metachronous Gastric Cancers Occurring after Endoscopic Resection for Early Gastric Cancers
Study (year) | Subject no. | Mean follow-up period (yr) | Incidence of metachronous cancer (%) | Risk factors |
---|---|---|---|---|
Abe |
1,526 | 6.8 | 15.6 | Multiple initial cancers |
Male sex | ||||
Sugimoto |
155 | 4.2 | 14.8 | Intestinal metaplasia |
Neutrophil infiltration | ||||
Mori |
594 | 4.5 | 13.3 | Male sex |
Severe atrophy | ||||
Multiple initial cancers | ||||
Ami |
539 | 8.7 | 13.0 | Old age (>60 yr) |
Current smoking | ||||
Cho |
2,334 | 3.5 | 3.3 | Aging |
Chung |
185 | 5.6 | 13.0 | Old age (>70 yr) |
Persistent Helicobacter pylori infection | ||||
Kwon |
590 | 4.0 | 10.8 | Persistent H. pylori infection |
Serum pepsinogen I/II ratio ≤3 | ||||
Okada |
384 | 4.1 | 15.6 | Aging |
Differentiated-type histology | ||||
Multiple initial cancers |
Table 1 Incidence and Risk Factors of Metachronous Gastric Cancers Occurring after Endoscopic Resection for Early Gastric Cancers
Study (year) | Subject no. | Mean follow-up period (yr) | Incidence of metachronous cancer (%) | Risk factors |
---|---|---|---|---|
Abe | 1,526 | 6.8 | 15.6 | Multiple initial cancers |
Male sex | ||||
Sugimoto | 155 | 4.2 | 14.8 | Intestinal metaplasia |
Neutrophil infiltration | ||||
Mori | 594 | 4.5 | 13.3 | Male sex |
Severe atrophy | ||||
Multiple initial cancers | ||||
Ami | 539 | 8.7 | 13.0 | Old age (>60 yr) |
Current smoking | ||||
Cho | 2,334 | 3.5 | 3.3 | Aging |
Chung | 185 | 5.6 | 13.0 | Old age (>70 yr) |
Persistent Helicobacter pylori infection | ||||
Kwon | 590 | 4.0 | 10.8 | Persistent H. pylori infection |
Serum pepsinogen I/II ratio ≤3 | ||||
Okada | 384 | 4.1 | 15.6 | Aging |
Differentiated-type histology | ||||
Multiple initial cancers |