Abstract：Objective To investigate the risk factors of recurrence in patients with early gastric cancer after endoscopic submucosal dissection (ESD).Methods The clinical data of 176 patients with early gastric cancer admitted to Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from June 2019 to June 2021 were retrospectively analyzed.All patients successfully completed ESD.They were followed up for 1 year,and were divided into recurrence group (n=25) and non-recurrence group (n=151) according to the presence or absence of recurrence.General information of two groups including gender,age,tumor location,diabetes mellitus,tumor diameter,degree of differentiation,depth of tumor invasion,smoking history,whether endoscopy was performed before surgery,the nature of surgical margins,the number of positive lymph nodes were statistically analyzed,and the related risk factors for recurrence after ESD were analyzed.Results After ESD treatment,25 of 176 patients with gastric cancer recurred,and the recurrence rate was 14.20%.The univariate analysis showed that the tumor diameter≥3 cm,the depth of tumor invasion was submucosal,no preoperative endoscopy,positive surgical margins,and the number of positive lymph nodes ≥6 were related to the recurrence of early gastric cancer after ESD,and the differences were statistically significant (P＜0.05).Gender,age,tumor location,combined diabetes,degree of differentiation,smoking history were not related to the recurrence of early gastric cancer after ESD,and the differences were not statistically significant (P＞0.05).Multivariate analysis of the logistic regression model showed that the tumor diameter≥3 cm (β=2.512, OR=12.324,95%CI=4.322-35.141),the depth of tumor invasion was submucosal (β=1.947, OR=7.007,95%CI=2.629-18.677),no preoperative endoscopy (β=2.215, OR=9.164,95%CI=2.992-28.070),positive surgical margins (β=2.080, OR=8.005,95%CI=3.170-20.212),the number of positive lymph nodes≥6 (β=1.898, OR=6.673,95%CI=2.600-17.132) were independent risk factors for early gastric cancer recurrence after ESD (P＜0.05 and OR≥1).Conclusion Patients with early gastric cancer have a higher risk of recurrence after ESD,which is mainly affected by factors such as tumor diameter ≥3 cm,the depth of tumor invasion was submucosal,no preoperative endoscopy,positive surgical margins,and number of positive lymph nodes ≥6.Great attention should be paid in clinical practice.
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