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Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastric cancers, involves removing only the malignant lesion, leaving the rest of the gastric mucosa at risk for metachronous gastric cancer (MGC). Investigators in Japan, where ESD is often performed, retrospectively reviewed records from 1526 consecutive patients with gastric cancer who had undergone ESD between 1999 and 2006 (with annual or biannual surveillance endoscopy).
During a median follow-up of nearly 7 years, 288 patients developed MGC; the cumulative incidence was 9.5% at 5 years, 13.1% at 7 years, and 22.7% at 10 years. ESD, performed in 215 patients, was considered curative in 183. One patient died from the initial tumor, and seven died of MGC; di…