Local Therapy for Early Gastric Cancer -A Point of Contact Between Surgical and Endoscopic Therapy-

Atsushi Nashimoto, Juei Sasaki

Division of Surgery, Niigata Cancer Center Hospital

In order to establish criteria for surgical local resection (SLR), which we regard as a meeting point between surgical and endoscopic therapy, clinicopathological factors were evaluated in the last consecutive 1,301 cases with solitary early gastric cancer (EGC). As a result, we determined the criteria for SLR to be (1) EGC of the elevated type, located in the upper third, and less than 3 cm in size, and (2) EGC of any type less than 1 cm in size. Twenty-four patients underwent SLR. Twelve patients were indicated because of severity, combination with far advanced other cancer or clinical misjudgment, and one patient was recurrent. The other 12 patients fit the criteria for SLR. All of them are alive and have a good quality of life (QOL). If the strict criteria are maintained, SLR is safe and satisfies the requirements of QOL. The actual survival of patients with EGC was excellent, namely, the 5-year survival rate was more than 95%. However, the number of aged patients with ECC has gradually increased. Wr should choose the most suitable therapeutic method, including SLE and endoscopic therapy, not only for radicality but also for the QOL of patients with ECG with consideration to the social and home environment.

Key words
early gastric cancer, endoscopic resection, surgical local resection

Reprint requests
Atsushi Nashimoto Department of Surgery, Nigata Cancer Center Hospital
2-15-3 Kawagishicho, Niigata City, 951 JAPAN

Accepted
June 14, 1993

To read the PDF file you will need Abobe Reader installed on your computer.