J.Jpn. Surg. Soc.. 93(9): 1071-1074, 1992
Report on the annual meeting
EVALUATION OF ENDOSCOPIC MUCOSAL RESECTION (EMR) AS A CURATIVE THERAPY AGAINST EARLY GASTRIC CANCER
|
The Second Department of Surgery, Kumamoto University, School of Medicine, Kumamoto, Japan Seiichi Mizumoto, Atsunobu Misumi, Kazunori Harada, Koichi Arima, Toshihiko Hirata, Ichiro Yoshinaka, Michio Ogawa |
In 256 radical operation cases, five year survival rates were 97.5% in m-cancer and 93.2% in sm-cancer. In these cases, postoperative complications occurred in 7.8%, with operative mortality being 0.78%.
In 56 EMR cases, nine encountered slight bleeding, which was controlled by ethanol injection under endoscopy. Regarding prognosis of EMR, cancer recurrences occurred in 45.8% of cases with stump involvement in the resected mucosa (stump (+) ). In cases without stump involvement in the resected mucosa (stump (-) ), no recurrence were found except one case, in which distance from the cancer edge to the stump was only 0.6mm, suggesting that enough distance (2mm) to the stump is required for curative EMR. Stump (-) rate was high (81.2%) in cases of small cancer less than 1cm in diameter, but was low in cases of cancer greater than 2cm and those located in upper body or lesser curvature. To establish EMR as a curative therapy, it must be performed by single collection to check remaining cancer.
In conclusion, although radical operation is still the standard curative therapy, EMR should be considered as an alternative therapy.
To read the PDF file you will need Adobe Reader installed on your computer.