RESUMEN
BACKGROUND/AIMS: The aim of this study was to determine whether the margin of early to be detected gastric cancer (EGC) and gastric adenoma is easier to be detected with autofluorescence imaging (AFI) than with white-light endoscopy (WLE). METHODS: A total of 102 lesions (48 EGCs and 54 gastric adenomas) found in 98 patients were removed endoscopically or surgically. The measured length of each pathology specimen was compared with the lengths estimated using WLE, AFI, and chromoendoscopy. RESULTS: The lesions could be discriminated from surrounding mucosa by AFI in 86 cases (84.3%). The detection rates were similar for elevated lesions (85.1%) and flat/depressed lesions (82.9%, p=0.770). In terms of histology, the detection rate was slightly higher for adenomas (90.7%) than for cancer (77.1%, p=0.058). The estimated length was shorter than the pathologic length in 31.4% of cases when using WLE and 22.1% of cases when using AFI (p=0.168). The resection range was larger for EMR than for AFI in 24 of 80 cases (30.0%). CONCLUSIONS: WLE tends to underestimate the size of EGCs, whereas AFI tends to overestimate their size.
RESUMEN
BACKGROUND: EMR has been accepted as a treatment modality for selected cases of early gastric cancer (EGC) in Japan. However, long-term outcomes after EMR for EGC have not been fully documented. OBJECTIVES: We reviewed the experiences of EMR for EGC in Korea, with emphasis on the long-term outcome. DESIGN: Multicenter, retrospective study. METHODS: Data were collected retrospectively by use of the on-line database registry system. From January 2000 to December 2002, 514 EGCs in 506 patients were treated by EMR in 13 institutions in Korea. Median age of the patients was 60 years (range 45-83 years). The resection was regarded as incomplete if histopathologic examination revealed a positive resection margin or submucosal invasion or positive lymphovascular invasion or undifferentiated histologic diagnosis. RESULTS: The most commonly used technique was circumferential precutting followed by snare resection (EMR-P, n = 269, 52.3%). Complete resection and incomplete resection after EMR were confirmed in 399 lesions (77.6%) and 103 lesions (20.0%), respectively. For completely resected mucosal cancers (n = 399), the median duration of follow-up was 23.5 months (range 5-70 months). In this group, local recurrence was detected in 24 cases (6.0%) with a median interval between EMR and recurrence of 17.9 months (range 3.5-51.7 months). There were 3 cases with perforation and 71 cases with bleeding. No deaths were related to recurrence of gastric cancer during the overall median follow-up period of 39 months. LIMITATIONS: Multicenter retrospective design, no controls. CONCLUSIONS: EMR is an effective therapeutic modality for selected cases of EGC in Korea.
