Long Term Prognosis of the Cases After EMR of Early Gastric Cancer

Autor: Shinichi Nakamura, Ryujirou Imai, Itaru Ohi, Shohei Shimizu, Ichirou Ishikawa, Izumi Shirato, Hiroyuki Konishi, Keiko Shiratori, Atsushi Mitsunaga
Rok vydání: 2006
Předmět:
Zdroj: Gastrointestinal Endoscopy. 63:AB187
ISSN: 0016-5107
DOI: 10.1016/j.gie.2006.03.421
Popis: Long Term Prognosis of the Cases After EMR of Early Gastric Cancer Atsushi Mitsunaga, Ryujirou Imai, Ichirou Ishikawa, Izumi Shirato, Shohei Shimizu, Hiroyuki Konishi, Shinichi Nakamura, Itaru Ohi, Keiko Shiratori Aim: There have been passed about 20 years after starting to perform the endoscopic mucosal resection (EMR) for early gastric cancer. Then we studied the long term prognosis of the cases after EMR. Method: Seven hundred and seventeen cases (814 lesions) were entree for this study. Those cases were performed EMR between 1983 and 2003, and followed up more over two years. Results: Six hundred and eight lesions (74.7%) were indicated cases and 206 lesions (25.3%) were contraindicated cases (indication was according to the guide line of Japanese Gastric Cancer Association). Thirty-two point nine percent of the contraindicated lesions were the cases of over 75 years old that were 24.6% of the whole cases. Ninety-six point five percent were differentiated lesions and the undifferentiated lesions were only 3.5% of all lesions. The cases of EMR for early gastric cancer have increased gradually but the mean age of the patients, which was about 70 years old, has never changed within this interval. The mean interval of the surveillance after EMR was 4 years and 9 months (min 2 years, max 19 years and 9 months). The planned surveillance after EMR was especially difficult in the aged patients. Heterogeneous early gastric cancer has occur in 4% of the whole cases and the relative risk of the heterogeneous early gastric cancer occurring was 3.42 in the simultaneous early gastric cancer cases. We could find about 50% of the heterogeneous early gastric cancer near by the first lesion. There was no difference in the prognosis after EMR between over 75 years patients and less than 75 years patients on the Kaplan-Meier survival curve excluding the death of complication. And there was no case of surgical operation due to the complication of EMR (containing 6 perforation cases) in all patients. Conclusion: Considering about there is no difference of the mean age of the EMR cases of early gastric cancer in spite of the tendency of aging of Japanese population, we are thinking that differentiated gastric cancer has occurred after some settled interval because such cancer grows in the atrophic mucosa after Helicobacter pylori infection. Heterogeneous multiple gastric cancer has occur in 4% cases after EMR of early gastric cancer, so it is suitable to follow continuously especially in the simultaneous multiple gastric cancer case at the first EMR. Even if in the aged patients, the prognosis after EMR for early gastric cancer was not different from the patient’s prognosis less than 75 years old. So considering about the QOL after EMR, we are thinking that especially the aged patients should take the benefit of EMR for the treatment of early gastric cancer.
Databáze: OpenAIRE
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