There are increasing cases of early gastric cancer with intramucosal invasion, which are untreatable using surgical or endoscopic mucosal resection (EMR) due to their high risk.
Currently, no adequate treatment is available for these patients.
In this study, researchers from Japan evaluated whether argon plasma coagulation (APC) was a effective and safe modality for treating early gastric cancer.
The research team assessed 20 men and 7 women diagnosed with gastric cancer with intramucosal invasion. These patients were considered poor candidates for surgical resection or EMR due to risk factors, such as severe cardiac failure or thrombocytopenia.
The team determined irradiation conditions for APC treatment using swine gastric mucosa.
|In 26 out of 27 patients there was no evidence of recurrence during follow up.|
They used an argon gas flow of 2 liters per minute, at a power setting of 60 W and a maximum irradiation time of 15 seconds per cm2.
The follow up period ranged from 18 to 49 months.
The researchers found that 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 there was no evidence of recurrence during the follow up period (median 30 months).
However, 1 patient showed recurrence 6 months after the treatment, but was successfully retreated.
No serious complications were found in any of the 27 patients; 3 patients experienced a feeling of abdominal fullness.
Dr Sagawa's team concluded, "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."