Retrospective Analysis of the Results of Strip Biopsy for Setting of Adequate Application of Endoscopic Submucosal Dissection for Early Gastric Cancer

Abstract

Aim: Endoscopic submucosal dissection (ESD) is powerful new method of endoscopic mucosal resection for early gastric cancer (EGC). However ESD has some short points such as relatively high cost and high incidence of complication compared with conventional safe and low cost strip biopsy (SB). To set the adequate application of ESD, we retrospectively analyzed the results of SB for EGC. Method: We analyzed the results of SB of 374 EGC lesions of 360 patients. The SB result was classified into local complete resection and incomplete resection. The relations between SB result and tumor location, maximum diameter, and one year local recurrence were analyzed. Results: The local complete resection was achieved by SB for 206 of 374 lesions, and there was no local recurrence after local complete resection. For 168 lesions of incomplete resection, the local recurrence was found in 23 lesions (13.7%). The local complete resection rate was only 29.6% in the cardiac part, 26.9% in the lesser curvature of the angular part of the stomach, and 28.1% of the lesions of over 2cm in diameter. The local recurrence rate was 32% in the lesions of the cardiac part and the lesser curvature of the angular part. Conclusion: Our SB result suggests that, ESD is needed for EGC of large size over 2 cm in diameter, location of cardiac part and angular part of the stomach.