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Background <p>Gastric adenocarcinoma of fundic gland type (GA-FG) is a rare subtype that typically arises in the upper stomach, making endoscopic submucosal dissection (ESD) technically challenging. Cap-assisted endoscopic mucosal resection (EMRC) is widely used for early gastric cancer due to its shorter procedure time and improved safety profile. We evaluated its efficacy and safety for GA-FG.</p> Methods <p>We retrospectively analyzed patients with GA-FG who underwent EMRC or ESD between April 2013 and September 2024. Outcomes included en bloc, complete, and curative resection rates; procedure time; and adverse events. Odds ratios (ORs) were estimated using logistic regression, and inverse probability of treatment weighting was applied for adjustment.</p> Results <p>We enrolled 70 patients with 77 lesions that were treated by EMRC (<i>n</i> = 57) or ESD (<i>n</i> = 20). En bloc resection was achieved in 100% of both groups. Complete resection rates were 96.5% for EMRC and 100% for ESD (<i>P</i> = 1.00). The EMRC group had significantly shorter median procedure time (6 vs. 46&#xa0;min, <i>P</i> &lt; 0.001) and fewer adverse events (OR 0.05, 95% CI 0.003–0.36; <i>P</i> = 0.002). No significant differences were found in curative resection (OR 3.47, 95% CI 0.86–14.08; <i>P</i> = 0.08) and intraoperative perforation (10% in the ESD group, 0% in the EMRC group; <i>P</i> = 0.06).</p> Conclusions <p>Our findings suggest that EMRC is a safe and effective treatment for GA-FG, offering shorter procedure times and a lower risk of complications compared with ESD.</p>

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Feasibility study of cap-assisted endoscopic mucosal resection for gastric adenocarcinoma of fundic gland type

  • 期刊论文

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  • 发表日期：

    2026年5月25日

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  • Risa Ashizaki,
  • Tetsuya Yoshizaki,
  • Yuta Higasa,
  • Hiroshi Tanabe,
  • Eri Nishikawa,
  • Shinya Hoki,
  • Ryosuke Ishida,
  • Hitomi Hori,
  • Tatsuya Nakai,
  • Chise Ueda,
  • Satoshi Urakami,
  • Hirofumi Abe,
  • Madoka Takao,
  • Toshitatsu Takao,
  • Masakyo Asahara,
  • Yoshinori Morita,
  • Takashi Toyonaga,
  • Yuzo Kodama

摘要

Background

Gastric adenocarcinoma of fundic gland type (GA-FG) is a rare subtype that typically arises in the upper stomach, making endoscopic submucosal dissection (ESD) technically challenging. Cap-assisted endoscopic mucosal resection (EMRC) is widely used for early gastric cancer due to its shorter procedure time and improved safety profile. We evaluated its efficacy and safety for GA-FG.

Methods

We retrospectively analyzed patients with GA-FG who underwent EMRC or ESD between April 2013 and September 2024. Outcomes included en bloc, complete, and curative resection rates; procedure time; and adverse events. Odds ratios (ORs) were estimated using logistic regression, and inverse probability of treatment weighting was applied for adjustment.

Results

We enrolled 70 patients with 77 lesions that were treated by EMRC (n = 57) or ESD (n = 20). En bloc resection was achieved in 100% of both groups. Complete resection rates were 96.5% for EMRC and 100% for ESD (P = 1.00). The EMRC group had significantly shorter median procedure time (6 vs. 46 min, P < 0.001) and fewer adverse events (OR 0.05, 95% CI 0.003–0.36; P = 0.002). No significant differences were found in curative resection (OR 3.47, 95% CI 0.86–14.08; P = 0.08) and intraoperative perforation (10% in the ESD group, 0% in the EMRC group; P = 0.06).

Conclusions

Our findings suggest that EMRC is a safe and effective treatment for GA-FG, offering shorter procedure times and a lower risk of complications compared with ESD.