PT  - JOURNAL ARTICLE
AU  - T Sagawa
AU  - T Takayama
AU  - T Oku
AU  - T Hayashi
AU  - H Ota
AU  - T Okamoto
AU  - H Muramatsu
AU  - S Katsuki
AU  - Y Sato
AU  - J Kato
AU  - Y Niitsu
TI  - Argon plasma coagulation for successful treatment of early gastric cancer with intramucosal invasion
AID  - 10.1136/gut.52.3.334
DP  - 2003 Mar 01
TA  - Gut
PG  - 334--339
VI  - 52
IP  - 3
4099  - http://gut.bmj.com/content/52/3/334.short
4100  - http://gut.bmj.com/content/52/3/334.full
SO  - Gut2003 Mar 01; 52
AB  - Background: In recent years, there has been an increasing number of cases of early gastric cancer (T1, NX) with intramucosal invasion, which are untreatable by surgical or endoscopic mucosal resection (EMR) because of their high risk. Currently, no adequate treatment is available for such patients. Aim: The main objective of this study was to evaluate whether argon plasma coagulation (APC) is an effective and safe modality for treating early gastric cancer untreatable by surgical resection or EMR. Methods: The study group comprised 20 men and seven women diagnosed with gastric cancer with intramucosal invasion who were considered poor candidates for surgical resection or EMR due to risk factors such as severe cardiac failure or thrombocytopenia. Irradiation conditions for APC treatment were determined using swine gastric mucosa. We used an argon gas flow of 2 l/min at a power setting of 60 W and a maximum irradiation time of 15 s/cm2. The follow up period of the 27 patients ranged from 18 to 49 months (median 30 months). Results: All lesions were irradiated easily, including areas anatomically difficult for EMR such as the gastric cardia or the posterior wall of the upper gastric body. In 26 of 27 patients (96%) there was no evidence of recurrence during the follow up period (median 30 months). One patient showed recurrence six months after the treatment but was successfully retreated. No serious complications were found in any of the 27 patients but three patients (11%) experienced a feeling of abdominal fullness. Interpretation: APC is a safe and effective modality for treatment of early gastric cancer with intramucosal invasion untreatable by surgical resection or EMR. However, further observations are necessary to determine the long term prognosis of patients undergoing this treatment.