Factors influencing occurrence of metachronous gastric cancer after endoscopic resection: a systematic review and meta-analysis
Background/Aims Metachronous gastric cancer (MGC) can occur after endoscopic resection for gastric cancer. Further studies on factors other than Helicobacter pylori infection are needed. This systematic review and meta-analysis aimed to evaluate risk factors for metachronous recurrence of endoscopic...
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| Format: | Article |
| Language: | English |
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The Korean Association of Internal Medicine
2023-11-01
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| Series: | The Korean Journal of Internal Medicine |
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| Online Access: | http://www.kjim.org/upload/kjim-2023-184.pdf |
| _version_ | 1797633937571315712 |
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| author | Younghee Choe Jae Myung Park Joon Sung Kim Yu Kyung Cho Byung-Wook Kim Myung-Gyu Choi |
| author_facet | Younghee Choe Jae Myung Park Joon Sung Kim Yu Kyung Cho Byung-Wook Kim Myung-Gyu Choi |
| author_sort | Younghee Choe |
| collection | DOAJ |
| description | Background/Aims Metachronous gastric cancer (MGC) can occur after endoscopic resection for gastric cancer. Further studies on factors other than Helicobacter pylori infection are needed. This systematic review and meta-analysis aimed to evaluate risk factors for metachronous recurrence of endoscopically resected gastric cancer. Methods We searched medical literature published by February 2023 and identified patients with MGC after endoscopic resection for gastric cancer. The occurrence of MGC and the presence of intestinal metaplasia (IM), severe atrophic gastritis (AG), and H. pylori infection were quantitatively analyzed. Results We identified 2,755 patients from nine cohort studies who underwent endoscopic resection for gastric cancer by 2018. Those with severe AG or presence of IM had a significantly higher incidence of MGC than those without (RR 2.00, 95% CI 1.35–2.98, I2 = 52% for severe atrophy on antrum; RR 7.08, 95% CI 3.63–13.80, I2 = 0% for antral IM). Absolute risk difference of MGC occurrence was 7.1% in those with severe AG and 9.2% in those with IM. The difference in incidence rate per 1,000 person-years was 17.5 person-years for those with severe AG and 24.7 person-years for those with IM. However, H. pylori eradication did not significantly affect the occurrence of MGC (RR 1.18, 95% CI 0.88–1.59, I2 = 10%). Conclusions Gastric cancer patients with severe AG or presence of IM had a 2.0-fold or 7.0-fold higher risk of MGC occurrence after endoscopic resection than those without, respectively. They need more stringent follow-up to monitor MGC occurrences (CRD42023410940). |
| first_indexed | 2024-03-11T12:00:44Z |
| format | Article |
| id | doaj.art-66d6e695eba64cb5b3092234ca10c7b3 |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-03-11T12:00:44Z |
| publishDate | 2023-11-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-66d6e695eba64cb5b3092234ca10c7b32023-11-08T05:34:55ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482023-11-0138683184310.3904/kjim.2023.184170851Factors influencing occurrence of metachronous gastric cancer after endoscopic resection: a systematic review and meta-analysisYounghee Choe0Jae Myung Park1Joon Sung Kim2Yu Kyung Cho3Byung-Wook Kim4Myung-Gyu Choi5 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Gastroenterology and Hepatology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Gastroenterology and Hepatology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaBackground/Aims Metachronous gastric cancer (MGC) can occur after endoscopic resection for gastric cancer. Further studies on factors other than Helicobacter pylori infection are needed. This systematic review and meta-analysis aimed to evaluate risk factors for metachronous recurrence of endoscopically resected gastric cancer. Methods We searched medical literature published by February 2023 and identified patients with MGC after endoscopic resection for gastric cancer. The occurrence of MGC and the presence of intestinal metaplasia (IM), severe atrophic gastritis (AG), and H. pylori infection were quantitatively analyzed. Results We identified 2,755 patients from nine cohort studies who underwent endoscopic resection for gastric cancer by 2018. Those with severe AG or presence of IM had a significantly higher incidence of MGC than those without (RR 2.00, 95% CI 1.35–2.98, I2 = 52% for severe atrophy on antrum; RR 7.08, 95% CI 3.63–13.80, I2 = 0% for antral IM). Absolute risk difference of MGC occurrence was 7.1% in those with severe AG and 9.2% in those with IM. The difference in incidence rate per 1,000 person-years was 17.5 person-years for those with severe AG and 24.7 person-years for those with IM. However, H. pylori eradication did not significantly affect the occurrence of MGC (RR 1.18, 95% CI 0.88–1.59, I2 = 10%). Conclusions Gastric cancer patients with severe AG or presence of IM had a 2.0-fold or 7.0-fold higher risk of MGC occurrence after endoscopic resection than those without, respectively. They need more stringent follow-up to monitor MGC occurrences (CRD42023410940).http://www.kjim.org/upload/kjim-2023-184.pdfatrophic gastritismeta-analysismetaplasiasecond primary neoplasmsstomach neoplasms |
| spellingShingle | Younghee Choe Jae Myung Park Joon Sung Kim Yu Kyung Cho Byung-Wook Kim Myung-Gyu Choi Factors influencing occurrence of metachronous gastric cancer after endoscopic resection: a systematic review and meta-analysis The Korean Journal of Internal Medicine atrophic gastritis meta-analysis metaplasia second primary neoplasms stomach neoplasms |
| title | Factors influencing occurrence of metachronous gastric cancer after endoscopic resection: a systematic review and meta-analysis |
| title_full | Factors influencing occurrence of metachronous gastric cancer after endoscopic resection: a systematic review and meta-analysis |
| title_fullStr | Factors influencing occurrence of metachronous gastric cancer after endoscopic resection: a systematic review and meta-analysis |
| title_full_unstemmed | Factors influencing occurrence of metachronous gastric cancer after endoscopic resection: a systematic review and meta-analysis |
| title_short | Factors influencing occurrence of metachronous gastric cancer after endoscopic resection: a systematic review and meta-analysis |
| title_sort | factors influencing occurrence of metachronous gastric cancer after endoscopic resection a systematic review and meta analysis |
| topic | atrophic gastritis meta-analysis metaplasia second primary neoplasms stomach neoplasms |
| url | http://www.kjim.org/upload/kjim-2023-184.pdf |
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