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- Title
Ablation of residual gastric tumor by argon plasma coagulation after endoscopic resection.
- Authors
Oh, Sooyeon; Kim, Sang; Choi, Ji; Jin, Eun; Kim, Jee; Im, Jong; Kim, Joo; Jung, Hyun; Kim, Sang Gyun; Choi, Ji Min; Jin, Eun Hyo; Kim, Jee Hyun; Im, Jong Pil; Kim, Joo Sung; Jung, Hyun Chae
- Abstract
<bold>Background: </bold>For residual gastric tumors (RT) found at the treated sites after endoscopic resections (ER), additional treatment options are additional ER, surgery or argon plasma coagulation (APC). Long-term efficacy of APC as the curative modality for RT has not been fully elucidated. This study aimed to investigate the efficacy and long-term outcome of APC for RT with relevant tumor factors.<bold>Methods: </bold>Eighty-two patients who received ER for gastric adenocarcinoma or adenoma and were subsequently treated with APC for RT were reviewed retrospectively. Characteristics of the tumors curatively ablated with single-session of APC and the non-curatively ablated were compared by multiple logistic regression analysis. Overall rate of curative ablation and follow-up duration was calculated.<bold>Results: </bold>Initial tumor size <20 mm [odds ratio for second residual recurrence (OR) 0.16; 95 % confidence interval (CI) 0.039-0.63], en-bloc resection (OR 0.16; 95 % CI 0.039-0.72), histologic complete resection (OR 0.14; 95 % CI 0.028-0.66) and RT with flat or depressed type (OR 0.20; 95 % CI 0.051-0.77) were significantly associated with curative ablation of RT by single-session of APC. Anterior wall or lesser curvature location showed a tendency toward curative APC, but not reached statistical significance (OR 0.36; 95 % CI 0.11-1.16). A total of 60 patients (73.2 %) achieved curative ablation after single-session of APC. Eleven among the patients (n = 22) with second or more residual recurrence achieved curative ablation with one or two more additional sessions of APC. Overall rate of curative ablation was 86.6 % (71/82). From the last APC, the final curative ablation group (n = 71) has been followed up for 49.7 ± 37.4 months.<bold>Conclusions: </bold>En-bloc resection, histologic complete resection, RT with flat or depressed type and initial tumor size less than 2 cm can be predictors of favorable clinical outcome of APC as an additional treatment for RT. For selected patients with RT, APC and close monitoring could be a reasonable alternative to immediate resection.
- Subjects
STOMACH tumors; ARGON plasmas; ENDOSCOPIC surgery; HEALTH outcome assessment; LOGISTIC regression analysis; CONFIDENCE intervals; TUMOR treatment; THERAPEUTICS; CARCINOGENESIS; ELECTROCOAGULATION (Medicine); ADENOCARCINOMA; ADENOMA; ANTHROPOMETRY; CANCER relapse; GASTROSCOPY; TREATMENT effectiveness; RETROSPECTIVE studies; ODDS ratio
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2017, Vol 31, Issue 3, p1093
- ISSN
1866-6817
- Publication type
Academic Journal
- DOI
10.1007/s00464-016-5069-5