Clinical outcomes of argon plasma coagulation for the treatment of gastric neoplasm

Surg Endosc. 2013 Sep;27(9):3146-52. doi: 10.1007/s00464-013-2868-9. Epub 2013 Feb 27.

Abstract

Background: There are insufficient reports on the outcomes and local recurrence rates for gastric neoplasms treated using argon plasma coagulation (APC). The purpose of this study was to analyze the clinical outcomes in early gastric cancer or gastric adenoma patients following APC treatment.

Methods: Seventy-one patients were enrolled and all underwent APC at the Asan Medical Center between July 2007 and August 2011. Clinical and oncological outcomes were analyzed.

Results: The median follow-up period was 20 months (interquartile range 13-29 months). Among the 71 patients we evaluated, nonlifting after submucosal saline injection was found in 35 patients and 15 patients (21.2%) experienced local recurrence with a median period of 10 months (IQR 5-13 months). The rate of local recurrence was higher in the nonlifting group and the 40-W group than in the lifting group and the 60- or 80-W groups (31.4 vs. 11.1%, p = 0.045 and 31.7 vs. 6.7%, p = 0.017, respectively). Multivariate analysis showed that the power setting with the 40-W and nonlifting groups after submucosal injection was associated with local recurrence.

Conclusions: APC therapy after submucosal saline injection using high power (60 or 80 W) appears to be an effective alternative in the management of gastric neoplasm.

MeSH terms

  • Adenoma / pathology
  • Adenoma / surgery
  • Aged
  • Argon Plasma Coagulation*
  • Female
  • Gastroscopy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Treatment Outcome