胃と腸49巻11号

2014年10月発行

今月の主題 胃癌ESD適応拡大病変の経過と予後 主題

胃癌ESD適応拡大病変（分化型優位）の経過と予後

著者： 鈴木晴久¹ 小田一郎¹ 阿部清一郎¹ 関口正宇¹ 森源喜¹ 池澤伸明¹ 岡本朋子¹ 田中寛人¹ 野中哲¹ 吉永繁高¹ 中島健¹ 関根茂樹² 斎藤豊¹

所属機関： ¹国立がん研究センター中央病院内視鏡科 ²国立がん研究センター中央病院病理科

ページ範囲：P.1559 - P.1568

要旨　当院で1999〜2006年までの間に術前適応を満たした初発の早期胃癌に対し，ESDを施行した患者は1,956例で，ESD後に適応拡大治癒切除（分化型優位）と判定された713例の予後を明らかにした（追跡完遂割合91.7％，観察期間中央値7.1年）．所属リンパ節転移を1例，局所再発と遠隔転移を1例，異時性癌を129例（18.1％）に認め，うち局所再発と遠隔転移の1例と異時性癌の2例の計3例が胃癌死した．5年全生存率，疾患特異的生存率，相対生存率は92.2％，99.9％，105.6％で，胃粘膜内癌外科切除例や一般の日本人対象集団と比べても予後良好であり，ESDは適応拡大病変に対し根治性の高い治療法であった．

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