ENDGSCGPIC TREATMENT FOR CASES OF EARLY GASTRIC CANCER WITHOUT ABSOLUTE INDICATION OF ENDOSCOPIC TREATMENT

Abstract

Absolute indication of endoscopic treatment for early gastric cancer is considered tohe histologically differentiated, less than 20 mm in diameter, intramucosal, and non-ulcerative carcinoma. In this study we evaluated the prognosis of 69 cases (701esions)ofearly gastric cancer, treated endoscopically, in which the indzcation of endoscopzc treat-ment was not absolute. These cases were not indicated for surgical operation because ofcomplications and advanced age. Furthermore, we analyzed 68 cases (75lesions)of earlygastric cancer operated on surgically in order to compare the prognosis of both groups. Twenty three (48.9%)of 471esions followed up for more than one year after endo-scopic treatment showed a complete cure locally. Cases with surgical operation and withendoscopic treatment showed 78.1%, and 37.8%of 5-year survival rate, respectively, sothe latter cases had a significantly poorer prognosis than the former. Considering onlydeath caused by gastric cancer, cases with surgical operation and with endoscopic treatmeat shoved 98.5%, and 79.9%of 5-year survival rate, respectively, and there is nosignificant difference between them. Furthermore, comparing between the prognosis ofcases with absolute indication and cases without absolute indication regarding the depth, histologic type, and size separately, submucosal cancer showed a significantly(P<0.05)poorer prognosis than intramucosal one. These results indicated that endoscopic treatment is effective for cases of early gastriccancer without absolute indication.