Risk and prognostic factors of invasive gastric cancer detection during surveillance endoscopy: Multi‐institutional cross‐sectional study

Esophagogastroduodenoscopy is important for the detection of curable gastric cancer (GC). However, there are no appropriate surveillance data during routine endoscopic inspections. This study aimed to clarify the risk factors of pT1b- or deeper-GC detection during surveillance endoscopy.This was a retrospective, multicenter, cross-sectional study conducted in 15 Japanese hospitals. We retrospectively analyzed patients with GC who had previously undergone surveillance endoscopy at each institution from January 2014 to March 2020. Patients who had undergone gastrectomy, non-infection of Helicobacter pylori (Hp), and those with intervals 3 months or10 years from a previous endoscopy were excluded.In total, 1085 patients with GCs detected during surveillance endoscopy were enrolled. The multivariate logistic analysis revealed that current Hp infection (odds ratio [OR], 2.18; 95% confidence interval [CI] 1.50-3.16) and a surveillance interval of1.5 years (OR, 1.96; 95% CI, 1.35-2.84) were independent risk factors for pT1b- or deeper-GC. The 5-year disease-specific survival (5y-DSS) rate of GC was significantly lower in patients with surveillance interval of1.5 years than in those with surveillance interval of ≤1.5 years (93.7% vs. 98.3%, P0.001). Similarly, the 5y-DSS rate of GC was significantly lower in patients with active Hp infection than in those without (93.7% vs. 99.4%, P0.001).In this study, a surveillance interval of1.5 years and current Hp infection were independent risk factors for detecting pT1b- or deeper-GC. Additionally, these factors were poor prognostic factors of the detected GC during surveillance endoscopy.