Korean J Gastroenterol.  2018 Aug;72(2):79-82. 10.4166/kjg.2018.72.2.79.

Guidelines for Endoscopic Resection of Early Gastric Cancer: Comparison of Japanese and European Guidelines

• Koh JS
• Joo MK

• KMID: 2418767
• DOI: http://doi.org/10.4166/kjg.2018.72.2.79

Abstract

An endoscopic resection is performed widely and has been established as a standard therapeutic modality for the treatment of early gastric cancer (EGC) without lymph node metastasis. On the other hand, the selection of suitable patients by a thorough pre-procedural evaluation is mandatory for the successful management of EGC. Moreover, a clear and unified interpretation of a resected specimen and the definition of a curative resection is the mainstay for decision-making of an additional surgical resection and post-procedural surveillance schedule. This paper summarizes the key statements of Eastern (Japan Gastroenterological Endoscopy Society) and Western (European Society of Gastrointestinal Endoscopy) guidelines for an endoscopic resection of EGC, regarding the clinical staging and indication; pre-operative evaluation; definition of a curative resection; and post-procedural surveillance, focusing on the similarities and differences between the two guidelines.

Keyword

Gastric cancer; Endoscopic mucosal resection; Guideline

MeSH Terms

Appointments and Schedules
Asian Continental Ancestry Group*
Endoscopy
Hand
Humans
Lymph Nodes
Neoplasm Metastasis
Stomach Neoplasms*

Figure

• 

  Fig. 1 Classification of the indication before an endoscopic resection. The black column indicates absolute indication, gray column expanded indication, and white column out of indication. M, intramucosal cancer; UL, finding of ulceration1; SM, submucosal cancer.

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  Fig. 2 Evaluation of the curability. The black column indicates a curative resection; the gray column denotes the expanded indication, curative resection; and the white column shows a non-curative resection. A curative resection and expanded indication, and a curative resection are confined to an en bloc R0 resection without lymphatic or vascular invasion. M, intramucosal cancer; UL, finding of ulceration1; SM1, submucosal cancer <500 µm.

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