The long term outcome of gastric non-invasive neoplasia. Issue 8 (15th July 2003)

• Record Type: Journal Article
• Authors: Rugge, M; Cassaro, M; Di Mario, F; Leo, G; Leandro, G; Russo, V M; Pennelli, G; Farinati, F
• Other Names: group-author.
• Is Part Of: Gut. Volume 52:Issue 8(2003)
• Page Start: 1111
• Page End: 1116
• Publication Date: 2003-07-15
• Subjects: gastric neoplasia -- gastric dysplasia -- gastric cancer; GC, gastric cancer -- EGC, early gastric cancer -- AGC, advanced gastric cancer -- EMR, endoscopic mucosal resections -- GC-nos, gastric cancer not otherwise specified; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.52.8.1111
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: The cancer risk associated with gastric non-invasive neoplasia (formerly dysplasia) is debated. This prospective long term follow up study investigates the clinicopathological behaviour of non-invasive gastric neoplasia (and related lesions), focusing on the cancer risk associated with each different histological phenotype. Patients and methods: A total of 118 consecutive cases (nine indefinite for non- invasive neoplasia; 90 low grade non-invasive neoplasia; 16 high grade non- invasive neoplasia; and three suspicious for invasive adenocarcinoma) with a histological follow up of more than 12 months (average 52 months; range 12–206) were prospectively followed up with a standardised protocol. Patients in whom gastric cancer was detected within 12 months from the initial diagnosis of non-invasive neoplasia were excluded, assuming that invasive carcinoma had been missed at the initial endoscopy procedure. Results: Non-invasive neoplasia was no longer detectable in 57/118 cases (48%), was unchanged in 32 (30%), and evolved into gastric cancer in 20 patients (17%). Evolution to invasive adenocarcinoma was documented in both low and high grade non-invasive neoplastic lesions (8/90 low grade; 11/16 high grade) and correlated with histological severity (low versus high grade) at baseline (p<0.001). Seventy five per cent of cancers occurring during the long term follow up were stage I. Conclusions: The risk of invasive gastric cancer increases with the histological grade of the non-invasive neoplasia. Following up non-invasive gastric neoplasia increases the likelihood of gastric cancer being detected in its early stages.