Gastrointest Interv.  2016 Mar;5(1):1-5. 10.18528/gii150024.

Endoscopic resection for early gastric cancer: The current controversies

• Xia XF
• Chiu PW

• KMID: 2308823
• DOI: http://doi.org/10.18528/gii150024

Abstract

Gastric cancer remained second commonest cancer worldwide. The diagnosis of early gastric cancer (EGC) is increasing in Japan and South Korea resulting in better oncological outcomes. Endoscopic resection (ER) is safe and effective treatment for EGC with minimal risk of lymph node metastasis. The oncological clearance of ER for EGC in expanded criteria remains controversial. Several retrospective studies showed that endoscopic submucosal dissection (ESD) achieved minimal local recurrence and excellent survival for EGC in expanded indications. With an increasing trend of cancer occuring in the aging population, ER will play a major role in treatment of EGC among elderly who usually have multiple comorbidities. Salvage gastrectomy is generally recommended for those with non-curative ESD, while further researches should be conducted to refine the risks of nodal metastasis for various submucosal EGCs. Endoscopic surveillance is recommended for long term follow-up of patients after curative ESD as the risk of metachronous cancer is significant. Eradication of Helicobacter pylori is generally recommended for EGC treated by ER with a view to reduce the risk of metachronous tumor.

Keyword

Early gastric cancer; Endoscopic resection; Endoscopic submucosal dissection

MeSH Terms

Aged
Aging
Comorbidity
Diagnosis
Follow-Up Studies
Gastrectomy
Helicobacter pylori
Humans
Japan
Korea
Lymph Nodes
Neoplasm Metastasis
Recurrence
Retrospective Studies
Stomach Neoplasms*