Pathophysiological and clinical aspects of gastric hyperplastic polyps

Table 1 The proposed management decisions and oncologic surveillance program regarding gastric hyperplastic polyps

Before endoscopic resection of GHPs

GHP without dysplasia or cancer, asymptomatic and small (< 5 mm) - surveillance not recommended

GHP symptomatic or larger than 5 mm - endoscopic resection recommended

GHP with dysplasia or cancer - endoscopic or surgical resection recommended

GHP not classified for removal due to the risk of postsurgical complications - periodic gastroscopies with representative biopsies every 1-2 yr

GHP in patients with high risk of gastric cancer1 - gastroscopies every 1-2 yr

GHP with dysplasia outside the polyp - consider subtotal gastrectomy and gastroscopies every 1-3 yr

After endoscopic resection of GHPs

After complete resection of GHP with dysplasia - gastroscopy 1 yr later, and then depending on the clinical situation

After complete resection of GHP with early gastric cancer - gastroscopy 1 yr after and then 3 yr after

After incomplete resection of GHP with gastric cancer - consider gastrectomy with lymphadenectomy

¹Family history of gastric cancer or OLGA 3-4 on histopathological examination. GHP: Gastric hyperplastic polyp.