[Endoscopic mucosal resection for early gastric carcinoma].

Endoscopic mucosal resection (EMR) has made it possible to perform radical resection of early gastric cancers in resectable cases. To extend the indications for EMR, we discuss the following. 1) Three hundred fifty-seven patients with 389 lesions of early gastric cancer who were treated either with whole-block resection or partial resection were analyzed to evaluate the recurrence rate by the method. The recurrence rate was 15.1% of 139 lesions treated with whole-block resection and 8.0% of 250 lesions treated with both methods. It is considered that partial resection with the marking procedure is very important to remove the cancer completely. 2) The management of recurrent cancer recognized at follow-up examination after EMR is very important for patients because these are operable cases. Of recurrent cancers, 80.5% were diagnosed within one year after EMR, and therefore during this period careful follow-up examinations should be done. The therapy used to treat these recurrent cancers was re-EMR in 26 cases and surgical operation in 15 cases. 3) Problems still remain concerning how to manage cancer invading the submucosa diagnosed after EMR.