[The significance of endoscopic treatment of early gastric cancer].

Gastric endoscopy could be an useful procedure in treating patients with early gastric cancer in certain conditions. We treated 24 patients with gastric cancer for whom no surgery was indicated because of serious complications or patient's refusal. Endoscopic local injection (ELI) with Mitomycin C (MMC), 5-fluorouracil (5-FU), and Picibanil (OK-432) was performed in 16 patients and polypectomy in 8 patients as radical treatment for primary gastric cancer. Of the 16 cases, ELI was effective in 9 cases of early gastric cancers, consisting of 4 cases with complete response (CR), additional 4 with a partial response (PR), but was ineffective in the remaining of all 3 cases of advanced cancers. ELI with MMC + 5FU was performed in 8 cases with an excellent response; 3 cases with CR and 3 cases with PR; 5 patients are alive, with the longest survival period of 54 months, and 2 patients died of other diseases. On the other hand, ELI with OK-432 was carried out in remaining 8 cases with no effective results, showing only 1 case with CR and another case with PR. Polypectomy was effective for 8 protruding type of early gastric cancers with the longest cancer-free period of 31 months. At present, although preoperative evaluation of the depth and range of cancer invasion is difficult, we would like to emphasize that ELI and polypectomy are procedures worthy to be attempted in patients with early gastric cancers with no nodal metastases for surgery is not indicated.