Outcomes of treatment of argon plasma coagulation therapy in elderly or high-risk patients with early gastric cancer: a comparison of outcomes among experienced and nonexperienced endoscopists.
OBJECTIVE
In the treatment of gastric cancer, argon plasma coagulation (APC) has certain merits, such as short operation time, easy procedure, and lack of serious complications compared with endoscopic mucosal resection or endoscopic submucosal dissection, suggesting that this modality may be appropriate for some patients with gastric cancer. The aim of this study was to assess the therapeutic outcomes of APC in aged and/or high-risk patients with early gastric neoplasm.


METHODS
Fifty gastric neoplastic lesions (25 early gastric cancers and 25 adenomas) in patients with severe complications were treated with APC and followed up for a mean of 3.6 years (range: 0.5 to 6.6 y). The long-term outcomes of APC therapy and its efficacy as a first-line treatment were compared in patients with those lesions treated by experienced and nonexperienced endoscopists.


RESULTS
Recurrence after APC therapy occurred in 5 lesions (10.0%), with an annual relapse rate of 1.8%. The mean time to recurrence was 1.5 years. The total procedure time of APC treatment was 14.5±2.6 minutes for experienced endoscopists and 16.4±2.2 minutes for nonexperienced endoscopists, with a significant time difference between the 2 groups (P<0.05). However, the outcomes did not differ by endoscopic experience. There were no serious complications, such as perforation, bleeding, or infection.


CONCLUSIONS
APC therapy seems to be a safe and useful treatment for patients with early gastric neoplasm and a high risk of severe complications. Equal therapeutic outcomes were obtained by experienced and nonexperienced endoscopists.
Tomita
Toshihiko
T
Division of Upper Gastroenterology, Department of Internal Medicine, Gastroenterology, Hyogo College of Medicine, Nishinomiya, Japan.
Arai
Eitatsu
E
Kohno
Tomoaki
T
Kondo
Takashi
T
Kim
Yongmin
Y
Oshima
Tadayuki
T
Hori
Kazutoshi
K
Watari
Jiro
J
Matsumoto
Takayuki
T
Miwa
Hiroto
H
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D057908:Argon Plasma Coagulation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011361:Professional Competence; D012306:Risk; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome