Endoscopic Mucosal Resection (EMR) as a Curative Treatment of Early Gastric Cancer

Choi, Kyoo Wan; Kim, Woo Ho; Song, In Sung; Kim, Chung Yong; Jung, Hyun Chae; Yoon, Jung Hwan; Lee, Dong Ho; Lee, Kook Lae; Lee, Jun Haeng; Kim, Byeong Gwan; Hwang, Jin Hyok; Jeong, Jun Oh; Lim, Young Seok; Lee, Dae Hee; Jeong, Woon Tae

Abstract

The endoscopic mucosal resection(EMR) is proposed by some Japanese investigators as a curative therapy of early gastric cancer(EGC) because of its minimal invasiveness and excellent results. To evaluate the possible role of EMR as a curative treatment modality of EGC, we retrospectively analyzed l9 casea with EGC initially treated by EMR in Seoul National University Hospital from December 1993 and January 1996. 1) The histologic diagnosis prior to EMR was adenocarcinoma in 12 cases(63%) and adenomatous polyp in 7 cases(38%), which were confirmed as adenocarcinoma after EMR. 2) The histologic curative resection was done in 7 cases(37%). Two cases of them showed recurrence of the gastric cancer and were treated by radical surgery. The other five cases have been closely observed by regular endoscopic examination without recurrence for the maximal period of 1~3 months. 3) Histoiogically inadequate resection(positive cancer cell in resection margin, submucosal cancer infiltration, or no cancer tissue in resected specimen) was done in 12 cases(73%). But two surgically resected cimens of them have no residual cancer cells, and there was no cancer cells in the follow-up biopsy of the other two patients. There 4 cases were seemed to he examples of buring effect of EMR 4) After excluding five depressed lesions greater than 1 cm is long diameter, nine lesions were curatively treated by EMR. So successful EMR rate for strictly indicated lesions wsa 64% 5) There was no signifieant complication related to the procedure. We thnnk that endoscopic mucosal resection has a potential role as a curative treatment modality in a highly selected patient with darly gastric cancer