Retrospective Analysis of the Results of Strip Biopsies to Determine the Indication for Endoscopic Submucosal Dissection for Early Gastric Cancer

Abstract

To determine the indication for endoscopic submucosal dissection, we retrospectively analyzed the results of strip biopsies for early gastric cancer. We studied 374 lesions of 360 patients with early gastric cancer. The resection results were classified into complete local resection and incomplete resection. The relations among the resection results and maximum tumor diameter, tumor location, and 1-year recurrence were analyzed. Complete local resection was achieved by strip biopsy for 206 of the 374 lesions (55.1%). For the 168 lesions with incomplete resection, local recurrence was found in 22. The rate of complete local resection in strip biopsy was significantly low, and the rate of local recurrence was significantly high for lesions exceeding 2 cm in diameter as well as for lesions of the cardiac part and the angular part of the lesser curvature. Our strip biopsy results suggest that endoscopic submucosal dissection is needed for early gastric cancer lesions larger than 2 cm in diameter and for those located in the cardiac part and angular part of the lesser curvature.