Hemangioma/surgery* ; Humans ; Precancerous Conditions ; Sternum/surgery*

Bone Neoplasms/diagnostic imaging* ; Hemangioendothelioma/surgery* ; Hemangioendothelioma, Epithelioid/surgery* ; Humans ; Precancerous Conditions

Biopsy ; methods ; Esophageal Neoplasms ; pathology ; surgery ; Esophagoscopy ; Esophagus ; pathology ; Humans ; Mucous Membrane ; pathology ; Precancerous Conditions ; pathology ; surgery

Breast Neoplasms ; pathology ; surgery ; Carcinoma, Ductal, Breast ; pathology ; surgery ; Cryoultramicrotomy ; Cytodiagnosis ; methods ; Female ; Histocytological Preparation Techniques ; methods ; Humans ; Intraoperative Care ; methods ; Precancerous Conditions ; pathology ; surgery

OBJECTIVETo evaluate the long-term outcomes of endoscopic argon plasma coagulation (APC) therapy for early esophageal cancer and precancerous lesions.

METHODSOne-hundred and seventy-one cases with early esophageal cancer (intramucosal carcinoma) and precancerous lesions were treated by APC from 1994 to 2005, and all the cases were followed up. One-hundred and sixty-eight (98.2%) cases were follow-up by endoscopic examination for several times. On average, each patient was endoscopically examined 2.8 times. The follow-up rate was 100%.

RESULTSThe precancerous lesion group had 160 patients. They were followed up for 5 years. 11 patients died of causes unrelated to cancer. The lesions developed into esophageal squamous cell carcinoma in five patients ( 2 died and 3 underwent esophagectomy). The remaining 144 cases survived without cancer. In this group, the esophageal cancer incidence rate is only 3.1% (5/160). The early cancer (i.e. intramucosal cancer) group had 11 patients. During the 5-year follow-up period, two patients died of causes unrelated to cancer,six patients had recurrence (4 patients died and 2 patients underwent esophagectomy), and only 3 patients survived without cancer. Therefore, the 5-year survival rate was only 27.3% (3/11).

CONCLUSIONSThe APC therapy for precancerous lesions of the esophagus is effective and successful. Indications should be carefully considered when treating early esophageal cancer such as intramucosal carcinoma by APC therapy.

Argon Plasma Coagulation ; methods ; statistics & numerical data ; Carcinoma, Squamous Cell ; surgery ; Endoscopy ; Esophageal Neoplasms ; surgery ; Esophagoscopy ; Follow-Up Studies ; Humans ; Precancerous Conditions ; surgery ; Survival Rate

OBJECTIVETo evaluate the efficacy and safety of endoscopic mucous resection with transparent cap (EMR-Cap) and endoscopic multi-band mucosectomy (MBM) in the treatment of early esophageal cancer and precancerous lesion.

METHODSA retrospective study was performed to review 30 EMR-Cap cases from December 2008 to December 2009 and 32 MBM cases from January 2010 to January 2011 of early esophageal cancer and precancerous lesions. The differences between these two techniques in efficacy, safety, and cost were compared.

RESULTSIn EMR-Cap group, the median resection time was 26(10-56) min and median procedure time was 43(22-81) min, significantly longer than those in MBM group [10(7-18) min and 32(28-45) min, P=0.036 and 0.038, respectively]. There were no significant differences between the two groups in total thickness and depth of resected lesions (P>0.05). In EMR-Cap group, the median cost was significantly higher than that of MBM group [(5466±354) vs. (4014±368) RMB, P=0.008)].

CONCLUSIONSEMR-Cap and MBM are minimally invasive, safe and effective methods in the treatment of early esophageal cancer and precancerous lesions. Compared to the EMR-Cap, MBM is simple with shorter treatment time and lower cost.

Aged ; Endoscopy ; methods ; Esophageal Neoplasms ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucous Membrane ; surgery ; Precancerous Conditions ; surgery ; Retrospective Studies ; Treatment Outcome

Humans ; Infant ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Male ; Mucin-1 ; metabolism ; Nephrectomy ; Precancerous Conditions ; metabolism ; pathology ; surgery ; Vimentin ; metabolism ; WT1 Proteins ; metabolism ; Wilms Tumor ; metabolism ; pathology ; surgery

Gastritis cystica profunda (GCP) is an uncommon hyperplastic benign lesion, and histologically characterized by hyperplasia and cystic dilatation of the gastric glands extending into the submucosal layer. GCP usually occurs at a gastroenterostomy site, although it can occasionally be found in an unoperated stomach. GCP is thought to be a possible precancerous lesion, since a few early gastric cancers associated with it were reported. Herein, we report a case of gastric adenoma associated with GCP in an unoperated patient. The sizes of both the GCP and adenoma overlying it have increased during a 10 year follow-up period. Adenoma on the latest biopsy showed low grade dysplasia, and it was successfully treated by endoscopic submucosal dissection.
Adenoma/complications/*diagnosis/surgery ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastritis/complications/*diagnosis/ultrasonography ; Gastroenterostomy ; Humans ; Precancerous Conditions ; Stomach Neoplasms/complications/*diagnosis/surgery ; Tomography, X-Ray Computed

Endoscopic mucosal resection with a ligation device (EMR-L) has become important in the curative treatment of precancerous lesions and early gastric cancers (EGCs), but little is known of the long-term efficacy and survival rates of EMR-L compared with surgical resection. We analyzed the therapeutic efficacy and safety of EMR-L in cases of EGC and precancerous lesions and compared the results of EMR-L with those of gastrectomy in patients with EGC over the same periods. EMR-L was performed on 20 EGCs and 54 precancerous lesions including tubular adenomas with or without severe dysplasias in 74 patients. Macroscopic type, size and location of the lesion were determined by endoscope, and the depth of invasion in EGCs was determined by endoscopic ultrasonography and confirmed by pathologic examination of the resected specimens. All the EGC cases were endoscopically followed up for at least 18 months (range, 18-66 months). Patients were selected that underwent subtotal gastrectomy and the survival rates were compared with those that underwent EMR-L. Complete resection was made in a single EMR-L treatment session in 61 cases (82.4%; 91.5%, were precancerous lesions and 65% were EGCs). After a repeat trial of EMR-L, the total rate of complete resection of precancerous lesions and EGCs was 92.6% and 85.0%, respectively. The survival rate of EGCs showed that complete resection by EMR-L resulted in 2 and 5 year survival rates of 100% and 95%, which are comparable to those of surgery (100% and 100%). This study suggests that EMR-L is a technically simple, minimally invasive and highly safe and effective treatment modality for selective EGCs, and offers an alternative to surgical treatment.
Adult ; Aged ; Aged, 80 and over ; Comparative Study ; Endoscopy, Digestive System* ; Female ; Gastrectomy ; Human ; Ligation/instrumentation* ; Male ; Middle Age ; Precancerous Conditions/surgery* ; Stomach Neoplasms/surgery* ; Time Factors

BACKGROUND/AIMS: It has been known that chronic trauma and inflammation of gallbladder (GB) mucosa by gallstones (GS) can induce epithelial dysplasia, carcinoma in situ, and invasive cancer. This study was designed to investigate the usefulness of cholecystectomy in patients with asymptomatic GS for the early diagnosis and removal of dysplasia or cancer. METHODS: From January 2004 to July 2008, the clinical records of 703 cases with GS who underwent cholecystectomy at Korea University Guro Hospital were reviewed, and the prevalence of dysplasia and cancer was analyzed. RESULTS: In symptomatic GS (542 cases) group, low grade dysplasia was found in 4 cases (0.74%) and high grade dysplasia in 1 case (0.18%). In asymptomatic GS (161 cases) group, low grade dysplasia was found in 4 cases (2.48%) and cancer in 2 cases (1.24%) (p=0.012 vs. symptomatic cases). Dysplasias in symptomatic GS group were not associated with polyps, but dysplasias and cancers in asymptomatic GS group were associated. Patients with asymptomatic GS and polyps were analyzed according to the size of polyps. In those (12 cases) with larger polyps (> or =1 cm), low grade dysplasia was found in 2 cases and cancer in 2 cases. And in those (12 cases) with smaller polyps (<1 cm), low grade dysplasia was found in 2 cases. CONCLUSIONS: Extending indication of prophylactic cholecystectomy in patients with asymptomatic GS without polyp to prevent GB dysplasia or cancer beyond the existing indication does not seem to be justifiable in Korea. However, further studies are needed in patients with asymptomatic GS and polyp of any size.
Adult ; *Cholecystectomy ; Diagnosis, Differential ; Female ; Gallbladder Neoplasms/*diagnosis/etiology ; Gallstones/complications/*surgery ; Humans ; Male ; Middle Aged ; Polyps/diagnosis/surgery ; Precancerous Conditions/*diagnosis ; Retrospective Studies