Can Indication for ESD for Early Gastric Cancer be Expanded? Akiko Takahashi 1 , Tsuneo Oyama 1 , Yoshinori Miyata 1 , Akihisa Tomori 1 , Kinichi Hotta 1 , Syuko Morita 1 , Masaki Tanaka 1 , Shinichi Furutachi 1 1Department of Gastroenterology, Saku Central Hospital, Saku, Japan Keyword: 早期胃癌 , ESD , 適応拡大 pp.1491-1499
Published Date 2006/10/25
DOI https://doi.org/10.11477/mf.1403100666
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 The indication for EMR decided by the Japanese Gastric Cancer Association is differentiated intramucosal adenocarcinoma less than 20mm in diameter and without ulceration. However, recently the indication has been expanding.

 Materials and methods: Early gastric cancers treated with endoscopic submucosal dissection(ESD)from January, 2000 to May, 2003, were divided into three groups : an indication group(82 patients with 84 lesions), an extended indication group(differentiated adenocarcinoma, 51 patients with 53 lesions)and a further extended indication group(undifferentiated adenocarcinoma, 3 patients with 3 lesions). There was no significant difference in background among the three groups.

 Results : There was no significant difference among the three groups in complications. The complete en-bloc resection rate was 95.2%, 86.8%, 66.7%, respectively. The local recurrence rate was 0% in all three groups. The three-year survival rate was 95.9%, 91.5%, 66.7%, respectively. In addition, the cause-specific survival rate was 100% in all three groups.

 Conclusion : The extended indication for ESD for early gastric cancer is based on sufficient reasons. The indication for ESD for undifferentiated adenocarcinoma needs to be investigated further, because the cases that have undergone ESD are few in number.

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