MODIFIED TREATMENT OF EARLY GASTRIC-CANCER - EVALUATION OF ENDOSCOPICTREATMENT OF EARLY GASTRIC CANCERS WITH RESPECT TO TREATMENT INDICATION GROUPS

The results of endoscopic treatment of early gastric cancers were eval uated. The lesions were divided into two groups: the group with an abs olute indication (AI) and the other with a relative indication (RI) fo r endoscopic treatment. Endoscopic mucosal resection (EMR) was perform ed on 106 lesions in 104 patients. In addition, 108 patients were trea ted by laser irradiation (LI). The status of the patients were seriall y assessed during the postoperative period. The residual rate in AI pa tients who underwent EMR was 30.3%, whereas the rate in RI patients wa s 80%. The residual rate in 70 AI patients who underwent LI was 0%. Al though the recurrence rate was 4.2%, the cumulative curative rate afte r additional treatments was 100%. The residual rate in RI patients who underwent LI, was 17.4%, and the recurrence rate was 13.2%. The cumul ative curative rate after additional treatments was 97.4%. In AI patie nts, the initial mode of treatment used was EMR Patients who exhibited residual cancerous tissue after EMR or those in whom EMR was difficul t to perform, either technically or otherwise, underwent LI. EMR was t he first choice therapeutic technique because endoscopic specimens obt ained could be subjected to histopathologic examination. In RI patient s, the conventional operation was the therapeutic technique of first c hoice. The LI procedure was performed in those who either refused surg ery or who could not undergo operative treatment for various reasons.