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Meeting report of the 72nd Japanese Gastric Cancer Congress

2000; Springer Science+Business Media; Volume: 3; Issue: 1 Linguagem: Inglês

10.1007/pl00011683

1436-3305

Hidenobu Watanabe, Masayoshi Mai, Tadakazu Shimoda, Masae Tatematsu, Atsushi Ochiai, Masaki Mori, Takeshi Sano, Takashi Aiko, Shigeaki Yoshida, Hiroshi Furukawa, Michio Kaminishi, Morio Koike,

Gastric Cancer Management and Outcomes

ulceration frequently occurs in the IIc area, resulting in the breakdown of the muscularis mucosae, followed by nodal metastasis.It has also been demonstrated that Undiff early cancers are frequently associated with horizontal infiltration into the middle layer of the mucosa.These have been the main reasons why Undiff tumors have not been considered to be suitable for EMR.The first three speakers discussed the possibility of EMR for Undiff tumors based on retrospective analyses of nodal metastasis in surgical series.J. Fujisaki, Jikei University, Tokyo, and A. Chonan, JR Sendai Hospital, proposed that EMR would be possible in some Undiff tumors, but the number of cases was too small to provide statistical evidence.H. Ono, National Cancer Center Hospital, Tokyo, showed the largest number of surgical cases (426 mucosal, Undiff tumors) and analyzed nodal metastasis.The only category of mucosal Undiff tumors that had no nodal involvement was those smaller than 10 mm and without intra-tumoral ulceration.Even in their large series, there were only 12 cases in this category.T. Oyama, Saku Central Hospital, Nagano, reported their experience of 17 EMRs for Undiff tumors.The rate of local recurrence was high (17.6%),but additional treatments, including surgery and laser therapy were successful.H. Shimao, Kitasato University, Kanagawa, presented the results of laser therapy for Undiff tumors in patients with high operative risks.Again, the rate of residual disease was high, but the treatment showed good palliative effects.T. Nakamura, Kobe National Hospital, reported photodynamic therapy for Undiff carcinomas.Their new method of 2-consecutiveday therapy was effective for the local control of Undiff tumors.In the discussion, the following criteria were approved for EMR of Undiff mucosal carcinomas: the tumor is smaller than 5 mm, or smaller than 10 mm without ulcer or ulcer scar; the resection is one-piece, The annual Congress of the Japanese Gastric Cancer Association (JGCA) was held at Niigata, February 17-19, 2000.In spite of the weather forecast for heavy snow in this famous ski district, the 1200 participants enjoyed a perfect blue sky during the 3 days of the meeting.Since the inauguration of the JGCA in 1997, this has been the first congress organized by a non-surgeon president.H. Watanabe, Professor of Pathology, Niigata University, made every effort to establish a program that a surgeon president would not conceive of, and 8 of the 13 major sessions had a theme related to pathological research.Summaries by the chairmen of the symposia, panels, and workshops are given below.Chairmen's summary of the symposia, panels, and workshops Symposium 1.To what extent is the endoscopic mucosal resection of undifferentiated-type adenocarcinoma allowed?(chaired by M. Mai, Kanazawa University, and T. Hamada, Social Health Insurance Hospital) Endoscopic mucosal resection (EMR) of early gastric cancer (EGC) is usually indicated for mucosal carcinoma of differentiated type (Diff).The indication of EMR for carcinomas of undifferentiated type (Undiff; poorly differentiated adenocarcinoma and signet ring cell carcinoma) is controversial.This symposium focused on the possibility of extending the current EMR criteria to Undiff tumors.It is known that one of the histopathological characteristics of Undiff carcinoma is that superficial