title: Pathological appearance of the stomach after endoscopic mucosal resection for early gastric cancer.
abstract: BACKGROUND
  The pathological findings of the resected stomach after endoscopic mucosal resection (EMR) for early gastric cancer were reviewed. EMR was indicated when a lesion consisting of well or moderately differentiated adenocarcinoma had a diameter of less than 2 cm.
  
  
  METHODS
  Of 39 patients with early gastric cancer were treated with EMR between 1990 and 1995, 11 required additional surgery.
  
  
  RESULTS
  Malignant tissue in the gastric wall was completely removed in four patients, while cancer cells remained in the mucosa adjacent to the scar in five and infiltrated into the submucosa in two. Most of these residual cancers were characterized by a lesion with a diameter exceeding 15 mm and by the location in the body or cardia of the stomach. Lymph node metastases were observed in one patient whose carcinoma invaded the deeper submucosal layer. Assessment of the depth of entire invasion from the endoscopically-resected specimen was correct for six of 11 patients.
  
  
  CONCLUSIONS
  Gastric carcinomas to be resected by EMR should be smaller, especially if located in the body or cardia. Accurate diagnosis of the width and depth of invasion is indispensable before proceeding to EMR. Surgery may be the treatment of choice when there is submucosal invasion.
authors.affiliation: Department of Surgery, Fukuoka City Hospital, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Korenaga
authors.forename: H
authors.initials: H
authors.lastname: Orita
authors.forename: S
authors.initials: S
authors.lastname: Maekawa
authors.forename: A
authors.initials: A
authors.lastname: Maruoka
authors.forename: K
authors.initials: K
authors.lastname: Sakai
authors.forename: T
authors.initials: T
authors.lastname: Ikeda
authors.forename: K
authors.initials: K
authors.lastname: Sugimachi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology* / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012086:Reoperation; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*