Examination of Endoscopic Mucosal Resection as a Curative Treatment of Early Gastric Cancer / 대한소화기내시경학회지

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) has been accepted as a treatment option for cases of early gastric cancer (EGC) where the probability of lymph node metastasis is low. The purpose of this study was to define the indication and limitation of EMR of EGC. METHODS: We studied thirty-five cases of EGC treated by EMR in Chungnam National University Hospital from January, 1999 to July, 2001. RESULTS: The rate of complete resection on EGC was 94.3% (33/35). The size affected the curability; 94.4% (17/18) of lesions less than 10 mm, 93.3% (14/15) of lesions 11 to 20 mm and 100% (2/2) of those larger than 20 mm were resected completely. The depth of cancer invasion also affected the curability; 100% of lesion was confined to mucosa while 71.4% of those invaded submucosa. Of the thirty-three lesions which were completely resected, twenty-seven lesions had no recurrences during the follow-up period, four lesions were residual cancers and two developed local recurrences. CONCLUSIONS: In curative treatement for EGC with EMR, although follow-up period was short there is a possibility that indications for EMR could extend to the elevated lesion which is larger than 20 mm and to the superficial submucosal (sm1) cancer.

Clinicopathological Study on Laterally Spreading Tumor (LST) / 대한소화기내시경학회지

BACKGROUND/AIMS: Laterally spreading tumors (LST) were growthed along the colonic wall. These tumors were high malignant potential compared to colon polyp. We analyzed clinicopathological characteristics of these tumors. METHODS: From June 1996 to June 2001, twenty nine patients were diagnosed by colonoscopy. These lesions were classificated macroscopic (granular type and nongranular type) and microscopic findings. RESULTS: 20 male and 9 female were enrolled (mean age, 68.1). Among the LST, 41.4% were 20~30 mm in diameter, and 7% were larger than 30 mm. According to macroscopic findings granular types were 72.4% (21/29) and nongranular types were 27.6% (8/29). In macroscopic findings, tubular types were 48.4% (14/29), malignant changes were 31.3% (9/29). Tumor size was only significant factor in malignant potential of LST (p=0.004). Endoscopic mucosal resection was performed in 72.4% (21/29), operation in 8 (27.6%). Rate of submucosal invasion in LST was 3.4% (1/29, sm1). Recurrent rate of endoscopic treatment group was 9.5% (2/21). CONCLUSIONS: Most of LST were good indication for endoscopic treatment, but larger tumor size and irregular surface of tumor were suspected to be submucosal invasion. Therefore these lesions were performed other procedures as endoscopic ultrasound or computerized tomography for invasion depth.