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Fine‐tuning the criteria for strip biopsy and endoscopic submucosal dissection improves the outcome of early gastric carcinoma treatment
Author(s) -
Nishikawa Jun,
Satake Masaaki,
Hamabe Kouichi,
Fukagawa Yuki,
Shirai Yasuyuki,
Kiyotoki Shu,
Saito Mari,
Okamoto Takeshi,
Sakaida Isao
Publication year - 2010
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2010.06340.x
Subject(s) - medicine , biopsy , endoscopic submucosal dissection , curvatures of the stomach , radiology , surgery , lesion , cancer , endoscopy , stomach
Abstract Background and Aim: Strip biopsy and endoscopic submucosal dissection (ESD) have been developed as a local treatment for early gastric cancer (EGC). However, the lesion criteria for the use of ESD, rather than strip biopsy, remain to be elucidated. Methods: On the basis of reviews of literature and our observations concerning the outcome of strip biopsy, we set the criteria for selecting strip biopsy and ESD as follows. The indications for strip biopsy were lesions less than 10 mm in size and located in the anterior wall or greater curvature of the lower and middle stomach. ESD was indicated for all other lesions. The validity of the criteria was then analyzed prospectively in 156 patients. The rate of en bloc R0 resection and local recurrence were evaluated. Results: Subsequently, 156 lesions were divided according to the criteria and were endoscopically resected by strip biopsy ( n = 13) or ESD ( n = 143). The en bloc R0 resection rates for the whole group and the strip biopsy and ESD groups was 93.5% (146/156), 92.3% (12/13), and 93.7% (134/143), respectively. None of the patients had suffered from local recurrence in either the strip biopsy or ESD groups. Conclusion: The validity of our criteria for selecting strip biopsy and ESD was verified. Our criteria exploit the advantages of both procedures and obtain better endoscopic therapy outcomes for EGC.