Abstract
From October 1987 to November 1994, endoscopic mucosal resection (EMR) for early gastric cancer was carried out in 154 lesions which had satisfied the criteria as follows, 1) less than 30mm in size, 2) solitary differentiated adenocarcinoma, 3) typeI, typeIIa, typeIIc or focal cancer macroscopically, 4) absence of fold-convergency. In the earlier period (from October 1987 to June 1992) EMR was performed with only single resection, and in the later period (from July 1992) EMR had been performed with single or multi-fragment resection (piecemeal resection) .
The rate of cut-end negative was 57% in the earlier period and 71% in the later period, respectively. The rate of cut-end negative by the location of lesions were 61% in M-area, 50% in A-area in the earlier period and 78% in M-area, 79% in A-area in the later period. The rate of cut-end negative in the C-area was relatively low (45% in earlier period and 33% in later period) . The rate of cut-end negative in lesser curvature was low (38%) in the earlier period but had improved in the later period (63%) .
The rate of curative resection, which had been judged as both cut-end negative and intramucosal cancer histologically, was 49% in the earlier period and 58% in the later period, respectively. During the follow-up of cases judged as curative resection, no local relapse had been observed in the cases of not only single resection but also multi-fragment resection. These data suggests the possibility of contribution of multi-fragment resection to the improvement of curative treatment and the possibility of application of radical EMR to larger lesions with multi-fragment resection.
