| Theme |
Expansion of Indications for Endoscopic Mucosal Resection of Early Gastrointinal Cancer |
| Title |
Some Problems with Expansion of Indications for Endoscopic Mucosal Resection of Early Gastric Carcinomas |
| Author |
Norishige Takemoto |
Division of Internal Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer |
| Author |
Kouichi Koizumi |
Division of Internal Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer |
| Author |
Tetsuichiro Muto |
Division of Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer |
| Author |
Akio Yanagisawa |
Department of Pathology, Cancer Institute, Japanese Foundation for Cancer |
| Author |
Yoh Kato |
Department of Pathology, Cancer Institute, Japanese Foundation for Cancer |
| Author |
Masakazu Maruyama |
Foundation for Detection of Gastric Early Carcinoma |
| [ Summary ] |
Some problems related to the expansion of the indications for endoscopic mucosal resection (EMR) were reconsidered, based on 934 early gastric cancer lesions, which bad been operated on between 1989 and 1998 at the Cancer Institute Hospital. At the present time, EMR is absolutely indicated for a lesion which satisfy the following conditions: in differentiated carcinoma a polypoid and elevated lesion measuring 20mm or less, without associated ulceration, and depressed lesions, measuring 10mm or less without associated ulceration. Recently, however, it has been proven that EMR can be carried out on some mucosal and submucosal carcinomial lesions which does not satisfy the current conditions for EMR indications. In our study, a new direction on the expansion of the indications for EMR was revealed. In cases of mucosa carcinoma, not associated with ulceration, all differentiated lesions and undifferentiated lesions measuring 20mm or less were indicated for EMR. In cases of mucosal carcinoma, which is associated with ulceration, undifferentiated lesions measuring 30mm or less and undifferentiated lesions measuring 5mm or less were indicated for EMR. In cases of submucosal carcinoma, which were not accompanied with ulceration or vessel permeation, differentiated lesions with the size of 30mm and the depth of submucosal invasion of 600 micron meter or less, and undifferentiated lesions under 10mm, and the depth of 600 micron meter and less were indicated for EMR. |