Follow-up result of endoscopic mucosal resection for gastric adenoma and early gastric cancer

Kwon, Chin Woo; Park, Cheol Hee; Cho, Jai Hyun; Jung, Jae One; Moon, Joon Ho; Shin, Woon Geon; Kim, Jong Pyo; Kim, Kyung Oh; Yoo, Kyo Sang; Hahn, Taeho; Park, Sang Hoon; Kim, Jong Hyeok; Kae, Sea Hyub; Park, Choong Kee

Abstract

BACKGROUND: Endoscopic mucosal resection (EMR) is now widely accepted as a useful treatment method for gastric adenoma and early gastric cancer (EGC) because of its minimal invasiveness and satisfactory post-procedure results. The purpose of this study is to define the follow-up results and usefulness of EMR.
METHODS
We analyzed 54 cases from June 2000 through September 2004. Endoscopy with histological examination was carried out every 3 months for 1 year after EMR.
RESULTS
The patients consisted of 42 men and 12 women, and the mean age was 60 years old. The histological results were 42 gastric adenoma and 12 EGC cases. There were 9 cases that had the histological diagnosis changes after EMR. Complete resections was performed for 48 cases and the en block resections were 33 of 34 cases (97%) and piecemeal resections were done in 15 of 20 cases (75%). Recurrence was seen in 4 cases (7.1%), and the mean recurrence period was 7 months. There were 3 gastric adenomas of 42 cases (7.1%), one case of EGC of 12 cases (8.3%), one en block resection of 34 cases (2.9%) and three piecemeal resections of 20 cases (15%).
CONCLUSIONS
EMR is a safe and useful treatment method for gastric adenoma and EGC. However, EMR has some limitations that EGC may have lymph node metastases or multiple tumors. So, periodic follow-up is very important. As we acquire more clinical experience, EMR may be accepted as the standard treatment method for gastric adenoma and EGC.