Pathological appearance of the stomach after endoscopic mucosal resection for early gastric cancer

Background The pathological findings of the resected stomach after endoscopic mucosal resection (EMR) for early gastric cancer were reviewed. EMR was indicated when a lesion consisting of well or moderately differentiated adenocarcinoma had a diameter of less than 2 cm. Methods Of 39 patients with e...

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Bibliographic Details
Published in:British journal of surgery 1997-11, Vol.84 (11), p.1563-1566
Main Authors: KORENAGA, D., ORITA, H., MAEKAWA, S., MARUOKA, A., SAKAI, K., IKEDA, T., SUGIMACHI, K.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Endoscopy
Follow-Up Studies
Gastric Mucosa - pathology
Gastric Mucosa - surgery
Gastroenterology. Liver. Pancreas. Abdomen
Gastroscopy
Humans
Male
Medical sciences
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Prognosis
Reoperation
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tumors
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Summary:Background The pathological findings of the resected stomach after endoscopic mucosal resection (EMR) for early gastric cancer were reviewed. EMR was indicated when a lesion consisting of well or moderately differentiated adenocarcinoma had a diameter of less than 2 cm. Methods Of 39 patients with early gastric cancer who were treated with EMR between 1990 and 1995, 11 required additional surgery. Results Malignant tissue in the gastric wall was completely removed in four patients, while cancer cells remained in the mucosa adjacent to the scar in five and infiltrated into the submucosa in two. Most of these residual cancers were characterized by a lesion with a diameter exceeding 15 mm and by the location in the body or cardia of the stomach. Lymph node metastases were observed in one patient whose carcinoma invaded the deeper submucosal layer. Assessment of the depth of entire invasion from the endoscopically‐resected specimen was correct for six of 11 patients. Conclusion Gastric carcinomas to be resected by EMR should be smaller, especially if located in the body or cardia. Accurate diagnosis of the width and depth of invasion is indispensable before proceeding to EMR. Surgery may be the treatment of choice when there is submucosal invasion.
ISSN:0007-1323
1365-2168
DOI:10.1111/j.1365-2168.1997.02847.x