A clinical study on residue and recurrence after endoscopic mucosal resection for early gastric mucosal carcinoma

To clarify the clinical management of histological margin positive cases after endoscopic mucosal resection (EMR) for early gastric cancer, we analyzed the therapeutic effect of additional treatment and the frequency of residue or recurrence after EMR in histologically incomplete resection cases. EMR was done for 91 cases in our hospital. 66 cases could be follow up and estimated for this study. As additional treatments for histologically incomplete resection cases, surgical resection was performed in 6 cases, laser irradiation was done in 9 cases, and electrocautery was done in 13 cases. Histologically, cancer remnant were not seen in any surgical resected specimens. Among 22 cases who received endoscopic additional treatment because of histological positive margin, residue of the cancer was demonstrated in two cases (9.1%). However, in 38 cases who showed histological negative margin, no cases was found to have residue or recurrnce. We conclude that immediate endoscopic additional treatment was effective for reducing the rate of residue and recurrence in the cases of histological positive margin after EMR.