Argon plasma coagulation for successful treatment of early gastric cancer with intramucosal invasion

Sagawa, T.; Takayama, T.; Oku, T.; Hayashi, T.; Ota, H.; Okamoto, T.; Muramatsu, H.; Katsuki, S.; Sato, Y.; Kayo, J.; Niitsu, Y.
March 2003
Gut;Mar2003, Vol. 52 Issue 3, p334
Academic Journal
Background: In recent years, there has been an increasing number of cases of early gastric cancer (T1, NX) with intramucosal invasion, which are untreatable by surgical or endoscopic mucosal resection (EMR) because of their high risk. Currently, no adequate treatment is available for such patients. Aim: The main objective of this study was to evaluate whether argon plasma coagulation (APC) is an effective and safe modality for treating early gastric cancer untreatable by surgical resection or EMR. Methods: The study group comprised 20 men and seven women diagnosed with gastric cancer with intramucosal invasion who were considered poor candidates for surgical resection or EMR due to risk factors such as severe cardiac failure or thrombocytopenia. Irradiation conditions for APC treatment were determined using swine gastric mucosa. We used an argon gas flow of 2 I/min at a power setting of 60 W and a maximum irradiation time of 15 s/cm². The follow up period of the 27 patients ranged from 18 to 49 months (median 30 months). Results: Alt lesions were irradiated easily, including areas anatomically difficult for EMR such as the gastric cardia or the posterior wall of the upper gastric body. In 26 of 27 patients (96%) there was no evidence of recurrence during the follow up period (median 30 months). One patient showed recurrence six months after the treatment but was successfully retreated. No serious complications were found in any of the 27 patients but three patients (11%) experienced a feeling of abdominal fullness. Interpretation: APC is a safe and effective modality for treatment of early gastric cancer with intramucosal invasion untreatable by surgical resection or EMR. However, further observations are necessary to determine the long term prognosis of patients undergoing this treatment.


Related Articles

  • Gastrectomy and D2 Lymphadenectomy for Gastric Cancer: A Meta-Analysis Comparing the Harmonic Scalpel to Conventional Techniques. Cheng, Hang; Hsiao, Chia-Wen; Clymer, Jeffrey W.; Schwiers, Michael L.; Tibensky, Bryanna N.; Patel, Leena; Ferko, Nicole C.; Chekan, Edward // International Journal of Surgical Oncology;5/14/2015, Vol. 2015, p1 

    The ultrasonic Harmonic scalpel has demonstrated clinical and surgical benefits in dissection and coagulation. To evaluate its use in gastrectomy, we conducted a systematic review and meta-analysis of randomized controlled trials comparing the Harmonic scalpel to conventional techniques in...

  • Towards a standardization of thrombin generation assessment: The influence of tissue factor, platelets and phospholipids concentration on the normal values of Thrombogram-Thrombinoscope assay. Gerotziafas, Grigoris T.; Depasse, François; Busson, Joël; Leflem, Lena; Elalamy, Ismail; Samama, Meyer M. // Thrombosis Journal;2005, Vol. 3, p16 

    Background: Thrombin generation assay was developed several years ago to mimic physiological coagulation mechanisms but it had important limitations. Thrombogram-Thrombinoscope assay using a fluorogenic substrate, allows obtaining thrombin generation curves in non-defibrinated platelet rich...

  • Plasma Levels of Thrombin-Activatable Fibrinolysis Inhibitor in Primary and Secondary Thrombocytosis. Kaftan, O.; Balcik, O. S.; Cipil, H.; Ozet, G.; Bavbek, N.; Koşsar, A.; Dagdas, S. // Clinical & Applied Thrombosis/Hemostasis;Oct2005, Vol. 11 Issue 4, p449 

    An elevated platelet count is a common finding in both hospitalized and ambulatory patients. Thrombosis and bleeding complications are more frequently observed in patients with clonal thrombocytosis than secondary thrombocytosis. The aim of this study was to investigate the behaviors of...

  • THE PRESERVATION OF COAGULATION FACTORS IN HUMAN PLASMA. Fantl, P.; Marr, A. G. // Australian Journal of Experimental Biology & Medical Science;Dec1956, Vol. 34 Issue 6, p433 

    The prolonged thrombin clotting time of sterile human oxalated or citrated plasma stored in open vessels at room temperature is not due to an increase of antithrombin, to heparin-like substances, nor to loss of thrombin-accelerating factors. It is due to a physical change of the surface...

  • Comparable Levels of Activity and Antigen in Factor XII Deficiency: A Study of 21 Homozygotes and 58 Heterozygotes. Girolami, A.; Gavasso, S.; Pacquola, E.; Cabrio, L.; Lombardi, A. M.; Girolami, B. // Clinical & Applied Thrombosis/Hemostasis;Jul2005, Vol. 11 Issue 3, p335 

    Results of coagulation studies on 21 homozygote patients with factor XII (FXII) deficiency revealed that all of them had no cross-reacting material (CRM) in their plasma. The 58 heterozygotes had in every instance an antigen level comparable to that of clotting activity namely, approximately 50%...

  • Evaluation of the association between FGBrs1800790 and plasma fibrinogen levels. Mashayekhi, A.; Shahbazi, Sh. // Scientific Journal of Iranian Blood Transfusion Organization;Spring2014, Vol. 11 Issue 1, p48 

    Background and Objectives Fibrinogen, coagulation factor 1, is a soluble plasma glycoprotein which converts thrombin to fibrin fibers in the coagulation cascade. Various polymorphisms located on beta chain gene, FGB, have been studied. The promoter - G455A (rs1800790) polymorphism had been shown...

  • Structural investigation of zymogenic and activated forms of human blood coagulation factor VIII: a computational molecular dynamics study. Venkateswarlu, Divi // BMC Structural Biology;2010, Vol. 10, p7 

    Background: Human blood coagulation factor VIII (fVIII) is a large plasma glycoprotein with sequential domain arrangement in the order A1-a1-A2-a2-B-a3-A3-C1-C2. The A1, A2 and A3 domains are interconnected by long linker peptides (a1, a2 and a3) that possess the activation sites. Proteolysis of...

  • TIPS FROM THE CLINICAL EXPERTS.  // MLO: Medical Laboratory Observer;Dec98, Vol. 30 Issue 12, p8 

    Responds to questions concerning medical laboratories. Quality control on semen analysis; Partial thromboplastin time plasma separation; Routine coagulation tests.

  • Tissue Factor Pathway Inhibitor Is a Potent Inhibitor of Plasmin. Klauser, Rainer J.; Hoppensteadt, Debra; Fareed Jawed // Clinical & Applied Thrombosis/Hemostasis;Apr1998, Vol. 4 Issue 2, p114 

    Recombinant tissue factor pathway inhibitor (TFPI) was found to be a potent inhibitor of plasmin. In an amidolytic assay the inhibition constant K, was found to be 2.86 x 108 M. TFPI in the same concentration range also inhibited the activation of plasminogen by tissue plasminogen activator...


Read the Article


Sign out of this library

Other Topics