Objective:

To compare clinical outcomes of simultaneous ESD for synchronous multiple early gastric neoplasms (SM-EGN) and solitary early gastric neoplasia (EGN), focusing on recurrence rates and predictors, and to assess implications for clinical practice.

Key Findings:

• Patients with SM-EGN had a higher cumulative risk of recurrence compared to those with solitary EGN, indicating a need for tailored follow-up.
• Field cancerization was identified as a significant factor influencing recurrence rates, suggesting a need for targeted management.
• The median follow-up time for OS was 50 months for SM-EGN patients and 54 months for solitary EGN patients, highlighting the importance of long-term monitoring.

Interpretation:

The study highlights the increased long-term recurrence risk in patients with SM-EGN, suggesting a need for more vigilant surveillance and management strategies to mitigate this risk.

Limitations:

• Single-center study may limit generalizability, potentially affecting the applicability of findings to broader populations.
• Retrospective design may introduce selection bias, which could influence the observed outcomes.

Conclusion:

Simultaneous ESD for SM-EGN is associated with higher recurrence rates, emphasizing the importance of understanding field cancerization in managing these patients.