Japanese

Endoscopic Submucosal Dissection for Early Gastric Cancer Tsuneo Oyama 1 , Akiko Takahashi 1 , Yoko Kitamura 1 , Akihisa Tomori 1 , Kin-ichi Hotta 1 , Yoshinori Miyata 1 1Department of Gastroenterology, Saku Central Hospital, Saku, Japan Keyword: 早期胃癌 , ESD , ESD適応 , ESD適応拡大 , 長期予後 pp.686-693
Published Date 2009/4/24
DOI https://doi.org/10.11477/mf.1403101640
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 Endoscopic mucosal resection(EMR)is a simple and safe method for the treatment of early gastric cancer. However, the size of a resected specimen is small, and piecemeal resection should be performed for a large lesion. Precise pathological diagnosis is difficult in piecemeal resected cases, and the local recurrent rate is higher in piecemeal resected cases compared with en bloc resected cases. Because of this,ESD was developed.

 The long term prognosis of early gastric cancer treated by ESD was investigated by 14 hospitals for the meeting of the Japan gastroenterological society. The patients were divided into three groups ; the indication group(well differentiated adenocarcinoma, mucosal, without ulcer and 2cm or less in size), the extended indication group 1(well differentiated adenocarcinoma, mucosal, without ulcer and 2.1cm or more in size),(well differentiated adenocarcinoma, mucosal, with ulcer and 3cm or less in size)or(well differentiated adenocarcinoma, 500 micrometer or less submucosal invasion and 3cm or less in size)and the extended indication group 2(poorly differentiated adenocarcinoma, mucosal, without ulcer and 2cm or less in size).

 The numbers of the indication, extended indication 1, and extended indication 2 group were 9033,4207 and 256, respectively. R0 resection rate(en bloc and with a negative lateral margin)in each group was 94.5%,86.4% and 90.9% respectively. Death through gastric cancer occurred at a rate of 0.01%(1/9,033),0.02%(1/4,207)and 0.4%(1/256). The long term prognosis of early gastric cancer treated by ESD was good, and the extension of the indication was considered as acceptable.


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

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