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KMID : 0614620030420060453
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Korean Journal of Gastroenterology
2003 Volume.42 No. 6 p.453 ~ p.460
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Usefulness of Endoscopic Mucosal Resection for Curative Treatment of Early Gastric Cancer
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Hyun Dong-Hyo
Jeong Seok
Lee Jin-Woo
Jeong Bong-Joo
Ryu Sung-Tae
Lee Chang-Kun
Kim Myung-Sik
Kwon Kye-Sook
Lee Don-Haeng
Kim Pum-Soo
Kim Hyung-Gil
Shin Yong-Woon
Kim Young-Soo
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Abstract
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BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) has been widely accepted as a curative treatment of early gastric cancer (EGC). The aim of this study was to determine the usefulness and limitations of EMR for treatment of EGC by analyzing our own experience.
METHODS: We retrospectively evaluated 51 EGC lesions (45 mucosal and 6 submucosal cancers) from 49 patients who had undergone EMR between Oct. 1997 and Aug. 2002 at Inha Universtiy Hospital.
RESULTS: Among 45 lesions of mucosal cancer, enbloc resection was performed in 13 lesions and piecemeal resection in 32 lesions. Complete resection rates of enbloc and piecemeal resection were 84.6% and 43.8%, respectively (p=0.012). Complete resection rate of the lesions smaller than 1 cm in size was 71.4%, 1 to 2 cm in size 52%, and greazter than 2 cm in size 37.5%. Complete resection rates of well, moderately, and poorly differentiated EGC were 59.4%, 71.4%, and 16.7%, respectively (p=0.048). Thirty-three patients underwent a follow-up endoscopy at I month after EMR and two were found to have residual cancers. One patient who had a piecemeal EMR showed cerical and abdominal lymph node metastasis 10 months after EMR.
CONCLUSIONS: In selected patients with EGC, EMR can be a curative treatment modality. However, complete resection rate is low in large sized and poorly differentiated EGCs and when piecemeal resection is performed.
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KEYWORD
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Stomach neoplasms, Early gastric cancer, Endoscopic mucosal resection
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