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KMID : 0882420070730040375
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Korean Journal of Medicine
2007 Volume.73 No. 4 p.375 ~ p.383
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Clinical outcome of endoscopic mucosal resection for treating early gastric cancer
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Lee Joon-Wook
Choi Myung-Gyu
Chung In-Sik
Kim Sang-Woo
Oh Jung-Hwan
Lee In-Seok
Paik Chang-Nyol
Park Jae-Myung
Cho Yu-Kyung
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Abstract
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Background: Endoscopic mucosal resection (EMR) has been widely accepted as a curative treatment for those cases of early gastric cancer (EGC) that have a low probability of lymph node metastasis. The aim of this study was to
evaluate the clinical outcome of EMR for the treatment of EGC.
Methods: We retrospectively analyzed the medical records of 50 patients who were finally confirmed to have EGC among the 214 patients who were treated with EMR at Kangnam St. Mary’s Hospital from January 1999 through
December 2004. The mean age of patients was 67.1 years (range: 47～83), and the male to female ratio was 7:3 (35/15).
The mean follow-up period was 20.5 months (range: 1～72).
Results: The mean size of the lesions was 16.6±7.4 mm. Forty-two cases (84%) were located in the lower third
of the stomach. There were 28 cases (56%) of endoscopically detected elevated lesions (type I, IIa). Complete resection
was achieved in 40 cases (80%). The complete resection rate was higher when the lesions had a diameter not exceeding
30 mm, when they were located in the lower third of the stomach and when they were the elevated macroscopic type.
The en bloc resection rate was the highest for endoscopic submucosal dissection. Of the 40 cases with complete resection, 6 cases (15%) developed local recurrence after a mean follow-up period of 12.3 months (range: 2～22). Of these 6 cases, 4 cases developed at previous EMR sites and 2 cases developed at other sites.
Conclusion: EMR is an effective method as a curative treatment for EGC with a high complete resection rate, but
some cases that are completely resected by EMR will experience recurrence. It is necessary to perform follow up at
established intervals for a long time after EMR
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KEYWORD
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Endoscopic mucosal resection, Early gastric cancer, Complete resection
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