위 신생물의 치료에 있어 아르곤 플라즈마 응고술의 적용

Abstract

Background & Aims: Argon plasma coagulation (APC) could be considered a treatment modality for small gastric neoplasms instead of endoscopic resection (ER). Our study investigated the clinical outcomes of APC for treating gastric neoplasms and associated variables with local recurrence.

Methods: This study included 1,408 patients who underwent APC for gastric neoplasms at the tertiary hospital from July 2007 to March 2022 with a minimal follow-up of 12 months. Through a retrospective review of medical data, the clinical outcomes and variables associated with the local recurrence were analyzed.

Results: A total of 796 patients (median age of 66 years old) were followed up for a median of 30 months and local recurrence has happened in 75 patients (9.42%). Multivariate analysis showed age (hazard ratio [HR] 1.05, 95% confidential interval [CI] 1.02¬-1.08), lesion size (HR 1.04, 95% CI 1.00-1.08), histology of cancer (HR 7.18, 95% CI 4.12-12.52), and scar change (HR 3.85, 95% CI 2.38-6.23) were associated with the local recurrence. Among lesions smaller than 10 mm without scar (n=557), local recurrence was found in 20 cases (3.6%), but local recurrence was in 37 cases (28.5%) with scar change (n=130) and in 18 cases (16.5%) in tumor larger than 10 mm (n=109).

Conclusions: In gastric neoplasm smaller than 10 mm without scars, APC is a good treatment modality in place of ER. However, when a lesion is larger or located on the scar, APC should be selected carefully with close monitoring