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Surgical Endoscopy

, 23:1581 | Cite as

The modern treatment of early gastric cancer: our experience in an Italian cohort

  • Filippo Catalano
  • Antonello Trecca
  • Luca Rodella
  • Francesco Lombardo
  • Anna Tomezzoli
  • Serena Battista
  • Marco Silano
  • Fabio Gaj
  • Giovanni de Manzoni
Article

Abstract

Background

Endoscopic submucosal dissection (ESD) has been developed as treatment for early gastric cancer (EGC) by Japanese authors. However, there are no reports about its possible implementation in the Western setting. The aim of the present work is to determine the safety and efficacy of the endoscopic treatments for EGC in an Italian cohort.

Methods

Forty-five patients for a total of 48 gastric lesions were enrolled in the study. Thirty-six EMR procedures were performed with the strip biopsy technique using a double-channel endoscope. En bloc resection refers to resection in one piece, while piecemeal refers to resections in which the lesion was removed in multiple fragments. A total of 12 ESD were performed and completed with IT knife. We define as curative treatment lateral and vertical margins of the resected specimens free of cancer and repeat endoscopic finding of no recurrent disease.

Results

Out of 36 EMR procedures, 10 were piecemeal resections (28%), while 26 were en bloc (72%). ESD led to en bloc resection in 11/12 cases (92%). Histological assessment of curability in the EMR group was achieved in 56% of the cases, and in 92% of the ESD group. Mean follow-up period was 31 months (range: 12–71 months). There was no local recurrence or distant metastasis in the curative group patients.

Conclusions

These results seem to confirm the safety and the clinical efficacy of the ESD procedure in the Western world too.

Keywords

Early gastric cancer Endoscopic mucosal resection Endoscopic submucosal dissection Endoscopic resection 

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Filippo Catalano
    • 1
  • Antonello Trecca
    • 2
  • Luca Rodella
    • 1
  • Francesco Lombardo
    • 1
  • Anna Tomezzoli
    • 3
  • Serena Battista
    • 2
  • Marco Silano
    • 4
  • Fabio Gaj
    • 5
  • Giovanni de Manzoni
    • 6
  1. 1.Department of Emergency EndoscopyUniversity of Verona OCM (Ospedale Civile Maggiore)VeronaItaly
  2. 2.Units of Operative Endoscopy and GastroenterologyRomeItaly
  3. 3.Department of HistopathologyUniversity of VeronaVerona Italy
  4. 4.Istituto Superiore di SanitàRome Italy
  5. 5.University La SapienzaRomeItaly
  6. 6.Department of General SurgeryUniversity of VeronaVerona Italy

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