Results of Endoscopic Mucosal Resection for Early Gastric Cancer-Factors Influencing Complete Resection-

Korean J Gastrointest Endosc > Volume 31(1); 2005 > Article

Korean Journal of Gastrointestinal Endoscopy 2005;31(1): 10-16.

조기위암에서 내시경 점막절제술의 치료성적 -완전 절제에 영향을 주는 인자들-

김범진·김재준·김지향·양정채·이준행·심상군·김영호·이풍렬·백승운·이종철·박철근*

성균관대학교 의과대학 삼성서울병원 내과학교실, *병리학교실

Results of Endoscopic Mucosal Resection for Early Gastric Cancer-Factors Influencing Complete Resection-

Beom Jin Kim, M.D., Jae J. Kim, M.D., Ji Hyang Kim, M.D., Jeong-Chae Yang, M.D., Jun Haeng Lee, M.D., Sang Kun Shim, M.D., Young-Ho Kim, M.D., Poong-Lyul Rhee, M.D., Seung Woon Paik, M.D., Jong Chul Rhee, M.D. and Chul Keun Park, M.D.*

Departments of Medicine and *Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Background/Aims:
The aim of the study is to evaluate the results of endoscopic mucosal resection (EMR) for early gastric cancer (EGC) and to investigate the factors with influence the complete resection.
Methods:
We retrospectively analyzed 109 lesions from 108 patients with EGC treated by EMR at Samsung medical center from November 1994 to June 2003. We compared completely resected group with incompletely resected group with regards to size, location, histologic types before and after EMR, methods of procedure, and complication.
Results:
The mean size of lesions was 11.3⁑6.5 mm. Eighty two of them were located in the antrum and angle, twenty six in the body, and one in the cardia of stomach. Endoscopically elevated lesions (type I, IIa) were 52 cases and depressed lesions (type IIc) were 40 cases. Histologically curative resection was done in 74 of 109 cases (67.9%). All but one cases have been observed without recurrence for a mean period of 11.1 months. Histologically incomplete resection in 35 cases included 9 positive cancer cell in resection margin, 25 submucosal cancer infiltration, 2 reconstruction failure, 1 lymphatic involvement and 1 signet ring cell type cancer. Complications related to EMR included 9 cases of bleeding and 3 cases of perforation. In comparison of two groups, complete resection rate was significantly higher when tumor was located in the antrum or angle than body or cardia of stomach (p=0.006).
Conclusions:
Our results show that EMR is one effective curative treatment modality in highly selected patient with EGC and location of lesion is an important factor influencing the success of complete resection. (Korean J Gastrointest Endosc 2005;31:10⁣16)

Key Words: Endoscopic mucosal resection, Early gastric cancer, Complete resection, Complication

주요어: 내시경 점막절제술, 조기위암, 완전 절제, 합병증