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[Early stomach cancer: endoscopic therapy].
Kongressband. Deutsche Gesellschaft Fur Chirurgie. Kongress
|February 5, 2002
Summary
Endoscopic resection is effective for early gastric cancers staged as low-risk. However, some low-risk cases recurred, necessitating further treatment, while high-risk cases had minimal residual disease post-surgery.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Endoscopy
Context:
- Early gastric cancer (EGC) endoscopic submucosal dissection (ESD) is typically reserved for low-risk lesions.
- Accurate pretherapeutic staging is crucial for selecting appropriate EGC patients for ESD.
Purpose:
- To evaluate the outcomes of endoscopic removal for EGCs initially staged as low-risk.
- To assess recurrence rates and the management of high-risk features identified post-resection.
Summary:
- Forty patients with presumed low-risk EGC underwent complete endoscopic removal.
- Pathological examination confirmed low-risk cancer in 75% of cases; 16% of these recurred and were re-treated.
- Of the 25% initially staged as high-risk, 11 underwent surgery with only 2 having residual tumors.
- The complication rate for endoscopic procedures was 10% (bleeding, perforation), with no mortality.
Impact:
- Endoscopic removal is a viable option for selected EGCs, but surveillance is essential due to recurrence risk.
- ESD can be safely performed with a low complication rate, improving patient outcomes.
- This study highlights the importance of pathological review and follow-up after endoscopic resection of EGC.