| Theme |
Significance, Problems, and Future Prospect of the Gastric Cancer Treatment Guideline |
| Title |
Follow-up Method for Endoscopic-Mucosal Resected Early Gastric Cancer and Additional Treatment for Residual and Locally Recurrent Gastric Cancer Treated with Endoscopic Mucosal Resection |
| Author |
Shigeaki Nagao |
2nd Internal Medicine, National Defence Medical College |
| Author |
Hitomi Tajima |
2nd Internal Medicine, National Defence Medical College |
| Author |
Kouji Matsuzaki |
2nd Internal Medicine, National Defence Medical College |
| Author |
Junichi Miyazaki |
2nd Internal Medicine, National Defence Medical College |
| Author |
Yoshitake Kitagawa |
2nd Internal Medicine, National Defence Medical College |
| Author |
Atsushi Kawaguchi |
2nd Internal Medicine, National Defence Medical College |
| [ Summary ] |
At this time, endoscopic treatment for early gastric cancer is expected to provide an absolute cure when lesions are limited to the intramucosal type and not accompanied by lymph node or other organ metastases. This method also provides better provides for the postoperative period with elderly patients than conventional surgical procedures. This is also true for patients with other surgical complications. Endoscopic mucosal resection provides the best cure rate for these lesions. However, when there has been incomplete resection, methods must de developed for futher treament. We discuss additional treatment of residual or recrrent cancer should be employed. If the edge of the incision is positive for cancer, fractionated, resection should be employed through repeated endoscopic mucosal resection to achieve complete resection. If submucosal cancer is found through endoscopic mucosal resection, careful observation, without additional treatment is possible as long as the vertical margin is free of cancer, in the lymphatic ducts and there is no vessel infiltration.
Semiconductor laser irradiation and additional surgery should be considered in these cases. |