| Endoscopic Mucosal Resection of Early Colon Cancer: Additional Therapy and Clinical Outcomes |
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Sang Gyune Kim, Chang Beom Ryu, Moon Sung Lee, Bong Min Ko, Sung Won Jung, Su Jin Hong, Young Seok Kim, Jin Oh Kim, Kye Won Kwon, Chan Sup Shim, Boo Sung Kim |
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Institute for Digestive Research, Department of Internal Medicine, Pathology, Soon Chun Hyang University College of Medicine, Bucheon and Seoul, Korea
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| 조기대장암의 내시경적 절제술: 추가치료와 임상적 고찰 |
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김상균, 유창범, 이문성, 고봉민, 정성원, 홍수진, 김영석, 김진오, 권계원, 심찬섭, 김부성 |
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순천향대학교 의과대학 내과학교실 소화기 연구소, 병리과 |
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| Abstract |
Background/Aims
The prevalence of early colon cancer is increasing and endoscopic removal of it has been widely accepted. After endoscopic resection, a number of remnant or recurrent tumors were managed successfully through salvage endoscopic mucosal resection (EMR) or argon plasma coagulation (APC). This study evaluated the outcomes of EMR for early colon cancer and efficacy of additional therapy in preventing recurrence. Methods: During the period from March 2001 to April 2004, a total of 50 early colon cancers were resected and analyzed retrospectively. EMR was performed either piecemeal by snare and cap aspiration or en bloc by conventional EMR and submucosal dissection. The patients were followed up at 3, 6, 12, 24 months and median follow up period was 21.8 months. By using the magnifying endoscopy, If the endoscopists judged the tumors incompletely excised or recurred. APC and EMR as additional therapy were done. Results: 50 early colon cancers comprised 44 mucosal cancers and 6 submucosal cancers in which en bloc resection was 34 (68%) and piecemeal resection was 16 (32%). Apart from the 13 cases which is unable to decide its lateral margin free because of piecemeal resection, Complete resection rate was 26/37(70.3%). The 20 cases receiving additional therapy consisted of en bloc resection 8 cases and piecemeal resection 12 cases. Recurrence rate of previous additional therapy was 1/20(5%) and had no significant difference with no additional therapy. Conclusions: For endoscopic treatment of early colon cancer En bloc resection is much better than piecemeal resection. Because of its high complete resection rate. But, in case of suggestive incomplete resection, recurrence rate will be decreased through the additional therapy. The long term results of additional therapy after EMR for Early colon cancer seem to be required for more study. (Intestinal Research 2004;2:65-70) |
| Key Words:
Early colon cancer, Endoscopic resection |
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