The Decision Concerning Complete Removal with Endoscopic Mucosal Resection (EMR) for Early Gastric Cancer:The Relationship between Resection Margin and Clinical Course in Single Fragment Resection Takuji Gotoda 1 , Hiroyuki Ono 1 , Hitoshi Kondo 1 1Department of Internal Medicine, National Cancer Center Hospital Keyword: 早期胃癌 , 内視鏡的粘膜切除術(EMR) , IT knife , 一括切除 , 水平切除断端 pp.1567-1572
Published Date 1998/11/25
DOI https://doi.org/10.11477/mf.1403103861
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 Our criteria for EMR include all of the following: - (1) Well or moderately differentiated adenocarcinoma,(2) Macroscopically I,IIa and IIc type and (3) The absence of ulcerative findings. The standards of size and multiplicity are also absolute, when each lesion completely satisfies the above (1) - (3).

 Four hundred and sixty-four lesions of early gastric cancer were treated with endoscopic mucosal resection (EMR) from 1987 through 1998 in the National Cancer Center Hospital. Of these subjects, 301 lesions under-went a single fragment resection. Then we evaluated the relationship between the resection margin and the clinical course. The resection margin was classified into four groups. There was no evidence of recurrence in 180 lesions which were histopathologically judged margin free (-). The recurrence rates of other groups [margin (±), margin (+), unknown] were 7%, 29% and 15%, respectively.

 These results suggest that it is necessary to prove margin (-) before it can be decided that resection will be curative. Furthermore, to decide the therapeutic course after EMR, histopathologically, it shold be elarified whether the resection margin (±) is actually margin (-) or margin (+).

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