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. 2024 Apr 17;16(4):e58467.
doi: 10.7759/cureus.58467. eCollection 2024 Apr.

Comparison of Prognosis and Metachronous Gastric Tumor Rates After Endoscopic Submucosal Dissection Between Gastric Neoplasm of Fundic Gland Type Neoplasms and Conventional Gastric Adenocarcinoma

Junnosuke Hayasaka  1 , Shu Hoteya  1 , Yugo Suzuki  1 , Yorinari Ochiai  1 , Yutaka Mitsunaga  1 , Hiroyuki Odagiri  1 , Akira Masui  1 , Daisuke Kikuchi  1 , Yutaka Takazawa  2
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Comparison of Prognosis and Metachronous Gastric Tumor Rates After Endoscopic Submucosal Dissection Between Gastric Neoplasm of Fundic Gland Type Neoplasms and Conventional Gastric Adenocarcinoma

Junnosuke Hayasaka et al. Cureus. .

Abstract

Introduction: Gastric neoplasm of the fundic gland type (GNFG) is a tumor with a good prognosis. However, since it has not been compared with conventional gastric adenocarcinoma (CGA), it is unknown whether it has a good prognosis or requires surveillance after treatment. The purpose of this study was to determine the prognosis and metachronous gastric tumor rates compared with those of CGA.

Methods: We conducted a single-center, retrospective, matched-cohort study using our database from January 2010 to December 2021. We extracted GNFG data from the endoscopic submucosal dissection (ESD) database and matched patients with conventional early gastric cancer as controls in a 1:4 ratio by age and sex. GNFG and CGA were compared for the overall survival (OS), disease-specific survival, progression-free survival, and metachronous gastric tumor rates.

Results: Overall, 43 lesions were GNFG and 164 CGAs were matched. There were three deaths in the GNFG group and 11 deaths in the CGA group. There was no significant difference in the OS between the two groups (P=0.81). The five-year OS rates for the GNFG and CGA groups were 90.9% and 92.9%, respectively. No disease-specific deaths or recurrences were observed in either group. There was no significant difference in the cumulative metachronous gastric tumor rate between the two groups (P=0.17). The cumulative five-year metachronous gastric tumor rates for the GNFG and CGA groups were 6.6% and 2.5%, respectively.

Conclusions: The prognosis for GNFG is good, however, not better than that for CGA. The metachronous gastric tumor rate after ESD in GNFG was not lower than that in CGA. Therefore, after ESD, GNFG may need to be managed in the same way as CGA.

Keywords: fundic gland type; gafg; metachronous tumor; oxyntic gland adenoma; prognosis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow chart of this study
Figure 2
Figure 2. OS rate of GNFG and CGA after ESD
The three-year OS rate was 91.2% in the GNFGs and 94.2% in the CGAs, which was not significantly different (P=0.86). OS: Overall survival; GNFG: Gastric neoplasm of the fundic gland type; CGA: Conventional gastric adenocarcinoma; ESD: Endoscopic submucosal dissection
Figure 3
Figure 3. Cumulative metachronous tumor rate of GNFG and CGA after ESD
The cumulative five-year metachronous gastric tumor incidence was 6.6% in GNFG and 2.5% in CGA, higher in GNFG but not significantly different (P=0.52). GNFG: Gastric neoplasm of the fundic gland type; CGA: Conventional gastric adenocarcinoma; ESD: Endoscopic submucosal dissection
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