Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study

BackgroundEndoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used techniques for the treatment of gastric epithelial dysplasia. Previous studies have compared the clinical outcome of endoscopic resection for early gastric cancer, but few studies have focused on gastric dysplasia alone. This study aimed to evaluate the long-term prognosis following endoscopic procedures for gastric epithelial dysplasia, investigate differences in local recurrence rates according to the treatment modality, and identify risk factors associated with local recurrence.MethodsIn this retrospective study, local recurrence rates and risk factors associated with local recurrence were compared between 599 patients who underwent EMR and 306 who underwent ESD for gastric epithelial dysplasia from January 2011 to December 2015.ResultsThe en bloc resection rate (32.2% vs. 100%, p2cm (p=0.002) or red in color (p=0.03). The ESD group had a significantly lower local recurrence rate, with a higher complete resection rate, than that in the EMR group (p2cm or showing redness due to an increased risk of local recurrence and EMR may be possible for low-grade dysplasia that is less than 2cm without surface changes such as redness, depression and nodularity.