<原著>胃癌 EMR 断端陽性症例の臨床病理学的検討

概要

論文の詳細を見る
Residual or recurrent diseases after endoscopic mucosal resection (EMR) for early gastric cancer were analyzed clinicopathologically to establish therapeutic guidelines for patients with positive surgical margin after EMR. A total of 75 patients with early gastric carcinoma undergone were subjected to the study. Eleven out of the 75 patients (14.1%) were pathologically judged to have had a surgical margin (+). Of the 11 patients, seven patients underwent a gastrectomy for additional treatment (AT; four cases) or recurrent disease (RD; three cases). Two AT patients had residual cancer. All of them had residual cancer with submucosal massive invasion (≩ sm 2) and the remaining one had lymph node metastasis. Two out of four AT patients had no residual cancer in their operated materials. All of them underwent EMR by piece-meal resection and the histological type of were differentiated adenocarcinoma. All three RD patients had recurrent mucosal cancer without lymph node metastasis. It is concluded that the cases of residual cancer with submucosal massive invasion (≩ sm 2) after EMR require gastrectomy with lymph node dissection; and that additional endoscopic treatment or local resection is indicated for cases of residual differentiated adenocarcinoma with mucosal and submucosal invasion (sm 1) undergone EMR by piece-meal resection.
新潟大学の論文
2002-03-10