Ablation of residual gastric tumor by argon plasma coagulation after endoscopic resection View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-06-28

AUTHORS

Sooyeon Oh, Sang Gyun Kim, Ji Min Choi, Eun Hyo Jin, Jee Hyun Kim, Jong Pil Im, Joo Sung Kim, Hyun Chae Jung

ABSTRACT

BackgroundFor 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.MethodsEighty-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.ResultsInitial 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.ConclusionsEn-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. More... »

PAGES

1093-1100

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-016-5069-5

DOI

http://dx.doi.org/10.1007/s00464-016-5069-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1047312929

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27351663


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    "description": "BackgroundFor 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.MethodsEighty-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.ResultsInitial tumor size <20\u00a0mm [odds ratio for second residual recurrence (OR) 0.16; 95\u00a0% confidence interval (CI) 0.039\u20130.63], en-bloc resection (OR 0.16; 95\u00a0% CI 0.039\u20130.72), histologic complete resection (OR 0.14; 95\u00a0% CI 0.028\u20130.66) and RT with flat or depressed type (OR 0.20; 95\u00a0% CI 0.051\u20130.77) 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\u00a0% CI 0.11\u20131.16). A total of 60 patients (73.2\u00a0%) achieved curative ablation after single-session of APC. Eleven among the patients (n\u00a0=\u00a022) 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\u00a0% (71/82). From the last APC, the final curative ablation group (n\u00a0=\u00a071) has been followed up for 49.7\u00a0\u00b1\u00a037.4\u00a0months.ConclusionsEn-bloc resection, histologic complete resection, RT with flat or depressed type and initial tumor size less than 2\u00a0cm 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.", 
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32 schema:description BackgroundFor 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.MethodsEighty-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.ResultsInitial 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.ConclusionsEn-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.
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38 schema:keywords ConclusionsEn bloc resection
39 MethodsEighty-two patients
40 ablation
41 ablation group
42 additional endoscopic resection
43 additional sessions
44 additional treatment
45 additional treatment options
46 adenocarcinoma
47 adenomas
48 alternative
49 analysis
50 anterior wall
51 argon plasma coagulation
52 characteristics
53 clinical outcomes
54 close monitoring
55 coagulation
56 complete resection
57 curative ablation
58 curative modality
59 curvature location
60 depressed type
61 duration
62 efficacy
63 en bloc resection
64 endoscopic resection
65 factors
66 favorable clinical outcome
67 gastric adenocarcinoma
68 gastric tumors
69 group
70 histologic complete resection
71 immediate resection
72 initial tumor size
73 location
74 logistic regression analysis
75 long-term efficacy
76 long-term outcomes
77 modalities
78 monitoring
79 months
80 multiple logistic regression analysis
81 options
82 outcomes
83 overall rate
84 patients
85 plasma coagulation
86 predictors
87 rate
88 reasonable alternative
89 recurrence
90 regression analysis
91 resection
92 residual recurrence
93 sessions
94 significance
95 sites
96 size
97 statistical significance
98 study
99 surgery
100 tendency
101 total
102 treatment
103 treatment options
104 tumor factors
105 tumor size
106 tumors
107 types
108 wall
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