Argon plasma coagulation for the treatment of early gastric cancer.

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) is widely used to treat early gastric cancer and is considered safe and effective. However, its indication range is limited. Other endoscopic treatment options are needed for patients with surgical risks. The aim of the study was to evaluate the safety and effectiveness of argon plasma coagulation (APC) for the treatment of early gastric cancer.

METHODOLOGY

APC was done in 23 patients (mean age, 77.5 years) with early gastric cancer. The depth of tumor invasion, estimated primarily by endoscopic ultrasonography, was mucosal in 19 patients and submucosal in 4. EMR was not indicated in 4 cases, and 14 cases were not successfully treated by EMR alone. All patients were followed up for more than 12 months (median, 42.0+/-20.8 months).

RESULTS

Fifteen patients had no recurrence and survived. Four patients had no recurrence, but died of causes other than gastric cancer. Cancer recurred in four patients. Recurrence was managed by repeated treatment with APC, with no technical problems. No serious complications occurred.

CONCLUSIONS

APC is useful for follow-up treatment of early gastric cancer after EMR. APC may also be effective for radical treatment of early gastric cancer, especially in elderly patients and patients in whom surgical intervention is contraindicated.