Dr Yanai and colleagues from Japan undertook a retrospective analysis of the impact of endoscopic mucosal resection (EMR), strip biopsy method, on the selection of subsequent treatment for early gastric cancer.
The researchers gathered information from a total of 163 consecutive patients with gastric epithelial tumors (186 lesions) who underwent strip biopsy.
On the basis of pretherapeutic findings, the research team classified indications for strip biopsy into 4 groups.
1. Benign-malignant borderline group (93 lesions),
2. Curative indication group (65),
3. Diagnostic indication group (22), and
4. Palliative indication group (6).
The researchers assessed the clinical impact of the strip biopsy result on the subsequent treatment strategy.
|Strip biopsy was effective treatment for 92.3% of lesions in the curative indication group|
The research team found that, of the lesions in the benign-malignant borderline group, 36.6% were intramucosal cancer.
In addition the team noted that the results of the strip biopsy in the curative indication group, differed from the pretherapeutic findings for 7.7% of the lesions.
The researchers found that strip biopsy was effective treatment for all lesions in the benign-malignant borderline group and for 92.3% of those in the curative indication group.
The research team observed that strip biopsy avoided unnecessary surgery in 50% of patients in the diagnostic indication group and 16.7% of those in the palliative indication group.
After the strip biopsy results were explained, 50% of the patients in the palliative indication group reversed their initial decision and opted for surgery.
Dr Yanai concluded, "Strip biopsy results reversed the decision for surgery, which had been based on inaccurate pretherapeutic information, in 20% of cases of early gastric cancer."
"Strip biopsy has a major clinical impact, because it provides an accurate diagnosis, aids in the selection of an appropriate treatment strategy, and reduces unnecessary surgery."