Feasibility study of cap-assisted endoscopic mucosal resection for gastric adenocarcinoma of fundic gland type.

IF 6.1 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastric Cancer Pub Date : 2026-09-01 Epub Date: 2026-05-25 DOI:10.1007/s10120-026-01762-7

Risa Ashizaki, Tetsuya Yoshizaki, Yuta Higasa, Hiroshi Tanabe, Eri Nishikawa, Shinya Hoki, Ryosuke Ishida, Hitomi Hori, Tatsuya Nakai, Chise Ueda, Satoshi Urakami, Hirofumi Abe, Madoka Takao, Toshitatsu Takao, Masakyo Asahara, Yoshinori Morita, Takashi Toyonaga, Yuzo Kodama

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引用次数: 0

Abstract

Background: Gastric adenocarcinoma of fundic gland type (GA-FG) is a rare subtype that typically arises in the upper stomach, making endoscopic submucosal dissection (ESD) technically challenging. Cap-assisted endoscopic mucosal resection (EMRC) is widely used for early gastric cancer due to its shorter procedure time and improved safety profile. We evaluated its efficacy and safety for GA-FG.

Methods: We retrospectively analyzed patients with GA-FG who underwent EMRC or ESD between April 2013 and September 2024. Outcomes included en bloc, complete, and curative resection rates; procedure time; and adverse events. Odds ratios (ORs) were estimated using logistic regression, and inverse probability of treatment weighting was applied for adjustment.

Results: We enrolled 70 patients with 77 lesions that were treated by EMRC (n = 57) or ESD (n = 20). En bloc resection was achieved in 100% of both groups. Complete resection rates were 96.5% for EMRC and 100% for ESD (P = 1.00). The EMRC group had significantly shorter median procedure time (6 vs. 46 min, P < 0.001) and fewer adverse events (OR 0.05, 95% CI 0.003-0.36; P = 0.002). No significant differences were found in curative resection (OR 3.47, 95% CI 0.86-14.08; P = 0.08) and intraoperative perforation (10% in the ESD group, 0% in the EMRC group; P = 0.06).

Conclusions: Our findings suggest that EMRC is a safe and effective treatment for GA-FG, offering shorter procedure times and a lower risk of complications compared with ESD.

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帽辅助内镜粘膜切除术治疗底腺型胃腺癌的可行性研究。

背景：胃底腺型腺癌（GA-FG）是一种罕见的亚型，通常发生在胃上部，这使得内镜下粘膜下剥离（ESD）在技术上具有挑战性。cap辅助内镜粘膜切除术（EMRC）因其手术时间短、安全性高而被广泛应用于早期胃癌。我们评价了其治疗GA-FG的有效性和安全性。方法：回顾性分析2013年4月至2024年9月期间接受EMRC或ESD治疗的GA-FG患者。结果包括整体切除率、完全切除率和治愈切除率；手术时间;以及不良事件。使用逻辑回归估计优势比（ORs），并使用处理加权的逆概率进行调整。结果：我们纳入了70例患者，共77个病变，采用EMRC （n = 57）或ESD （n = 20）治疗。两组患者全部切除。EMRC的完全切除率为96.5%，ESD的完全切除率为100% （P = 1.00）。结论：我们的研究结果表明，与ESD相比，EMRC组是一种安全有效的GA-FG治疗方法，手术时间更短，并发症风险更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastric Cancer 医学-胃肠肝病学

CiteScore

14.70

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.