title: Fine-tuning the criteria for strip biopsy and endoscopic submucosal dissection improves the outcome of early gastric carcinoma treatment.
abstract: OBJECTIVE
  Strip biopsy and endoscopic submucosal dissection (ESD) have been developed as a local treatment for early gastric cancer (EGC). However, the lesion criteria for the use of ESD, rather than strip biopsy, remain to be elucidated.
  
  
  METHODS
  On the basis of reviews of literature and our observations concerning the outcome of strip biopsy, we set the criteria for selecting strip biopsy and ESD as follows. The indications for strip biopsy were lesions less than 10 mm in size and located in the anterior wall or greater curvature of the lower and middle stomach. ESD was indicated for all other lesions. The validity of the criteria was then analyzed prospectively in 156 patients. The rate of en bloc R0 resection and local recurrence were evaluated.
  
  
  RESULTS
  Subsequently, 156 lesions were divided according to the criteria and were endoscopically resected by strip biopsy (n = 13) or ESD (n = 143). The en bloc R0 resection rates for the whole group and the strip biopsy and ESD groups was 93.5% (146/156), 92.3% (12/13), and 93.7% (134/143), respectively. None of the patients had suffered from local recurrence in either the strip biopsy or ESD groups.
  
  
  CONCLUSIONS
  The validity of our criteria for selecting strip biopsy and ESD was verified. Our criteria exploit the advantages of both procedures and obtain better endoscopic therapy outcomes for EGC.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan. junnis@yamaguchi-u.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Nishikawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Satake
authors.forename: Kouichi
authors.initials: K
authors.lastname: Hamabe
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fukagawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Shirai
authors.forename: Shu
authors.initials: S
authors.lastname: Kiyotoki
authors.forename: Mari
authors.initials: M
authors.lastname: Saito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamoto
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D004210:Dissection / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome