ENDOSCOPIC TREATMENT FOR EARLY GASTRIC CANCER : THE STUDY OF RESIDUE, RECURRENCE, AND PROGNOSIS AFLTER ENDOSCOPIC MUCOSAL RESECTION, INCLUDING PIECEIMEAL RESECTION AND ADDITIONAL USE OF LASER IRRADIATION

Abstract

We evaluated residue, recurrence, and prognosis of 65 intramucosal gastric cancerstreated by endoscopic mucosal resection(EMR), including piecemeal resection or additional use of laser irradiation. Clinical features of 651esions were histologically differentiated type, intramucosal Ul(-), ly(-), and v(-). They were all tried to treat with curativeendoscopic therapy. Twelve lesions of them were more than 20mm in diameter. Twenty five lesions resected once for all had no residue and recurrence in the follow-up period(range, 3-118 rnonths;mean, 32 months). Ten lesions resected piecemeal hadresidue of 1 lesion(operated additionally), and no recurrence(range 4-60 months;mean, 27months). Thirty lesions treated by EMR with additional laser irradiation had residue of 21esio:ns(operated additionally), and recurrence of l lesion(21 months after)(range, 4-92months;rnean, 25 months). Twelve lesions more than 20mm in diameter had:no recu.rrence.There were no cases who died of gastric cancer. Regarding end.oscopic treatment for earlygastric cancers, both piecemeal EMR and additional use of laser irradiation are consideredto be curative as well as EMR once for all. Furthermore, it is suggested that even lesionsmore than 20rnrn in diafneter can be curatively treated except for the case in condition ofendoscapically technical difficulty.