{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:33:59Z","timestamp":1784068439825,"version":"3.55.0"},"reference-count":16,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T00:00:00Z","timestamp":1677801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pusan National University Yangsan Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Endoscopic submucosal dissection (ESD) is considered the treatment of choice for early gastric cancer (EGC) with a negligible risk of lymph node metastasis. Locally recurrent lesions on artificial ulcer scars are difficult to manage. Predicting the risk of local recurrence after ESD is important to manage and prevent the event. We aimed to elucidate the risk factors associated with local recurrence after ESD of EGC. Between November 2008 and February 2016, consecutive patients (n = 641; mean age, 69.3 \u00b1 9.5 years; men, 77.2%) with EGC who underwent ESD at a single tertiary referral hospital were retrospectively analyzed to evaluate the incidence and factors associated with local recurrence. Local recurrence was defined as the development of neoplastic lesions at or adjacent to the site of the post-ESD scar. En bloc and complete resection rates were 97.8% and 93.6%, respectively. The local recurrence rate after ESD was 3.1%. The mean follow-up period after ESD was 50.7 \u00b1 32.5 months. One case of gastric cancer-related death (0.15%) was noted, wherein the patient had refused additive surgical resection after ESD for EGC with lymphatic and deep submucosal invasion. Lesion size \u226515 mm, incomplete histologic resection, undifferentiated adenocarcinoma, scar, and the absence of erythema of the surface were associated with a higher risk of local recurrence. Predicting local recurrence during regular endoscopic surveillance after ESD is important, especially in patients with a larger lesion size (\u226515 mm), incomplete histologic resection, surface changes of scars, and no erythema of the surface.<\/jats:p>","DOI":"10.3390\/jcm12052018","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T03:32:52Z","timestamp":1677814372000},"page":"2018","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6670-4420","authenticated-orcid":false,"given":"Dae-Gon","family":"Ryu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3816-9664","authenticated-orcid":false,"given":"Su-Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8867-3039","authenticated-orcid":false,"given":"Cheol-Woong","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1573-2792","authenticated-orcid":false,"given":"Su-Bum","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong-Seok","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1923-4777","authenticated-orcid":false,"given":"Si-Hak","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun-Hwi","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.ijsu.2019.11.027","article-title":"Updated evaluation of endoscopic submucosal dissection versus surgery for early gastric cancer: A systematic review and meta-analysis","volume":"73","author":"Liu","year":"2020","journal-title":"Int. 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Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1055\/s-0034-1391284","article-title":"Long-term survival after endoscopic resection versus surgery in early gastric cancers","volume":"47","author":"Kim","year":"2015","journal-title":"Endoscopy"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Japanese Gastric Cancer Association (2017). Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric. Cancer, 20, 1\u201319.","DOI":"10.1007\/s10120-016-0622-4"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"(2003). The Paris endoscopic classification of superficial neoplastic lesions: Esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest. 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Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/S0016-5085(57)80113-9","article-title":"Multiple gastric cancers; review of the literature and study of 42 cases","volume":"32","author":"Moertel","year":"1957","journal-title":"Gastroenterology"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/5\/2018\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:46:53Z","timestamp":1760122013000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/5\/2018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,3]]},"references-count":16,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["jcm12052018"],"URL":"https:\/\/doi.org\/10.3390\/jcm12052018","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,3]]}}}