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Surveillance after Endoscopic Resection of Early Gastric Cancer Osamu Hosokawa 1 , Yasuharu Kaizaki 2 , Naoyuki Ibe 3 1Department of Surgery, Fukui Prefectural Hospital 2Department of Pathology, Fukui Prefectural Hospital 3Department of Gastroenterology, Fukui Prefectural Hospital Keyword: 早期胃癌 , 内視鏡的切除 , 遺残再発 , 多発癌 , サーベイランス pp.1623-1632
Published Date 2005/11/25
DOI https://doi.org/10.11477/mf.1403100250
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 Since the advent of endoscopic submucosal dissection, the indication for endoscopic mucosectomy has been expanded to include half of the differentiated early gastric cancers. However, little is known about reasonable surveillance after endoscopic resection of early gastric cancer. We surveyed 190 patients with periodic endoscopic examinations after such a procedure. A total of 18 patients (9.5%) were diagnosed as having residual cancer. The mean interval from mucosectomy to the diagnosis was 208 days. The residual rate was higher statistically in the upper gastric region (p<0.01). The cumulative one-year residual rate was estimated as 8.8%, the two-year residual rate as 9.7% and the three-year residual rate as 12.4%. The residual cancer was not until detected after three years. A total of 21 new lesions were detected endoscopically. The mean interval from mucosectomy to diagnosis was 768 days. The macroscopic type was the same in 8 lesions compared with the initial lesion but 13 lesions were different. Fourteen lesions were detected near the initial lesions but 7 lesions were detected far from the initial lesions. The cumulative one-year prevalence rate was estimated as 5.6%. The rate increased to 26.9% by the time seven years had elapsed.

 Periodical surveillance examination for detecting new lesions is recommended after endoscopic resection of early gastric cancer. The examinations might be repeated at one-year interval and special attention should be paid to the region near the initial lesion.


Copyright © 2005, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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