J Dig Cancer Res.
2020 Jun;8(1):1-50.
Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
- Affiliations
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- 1Department of Gastroenterology, Hanyang University Guri Hospital, Guri, Korea
- 2Department of Gastroenterology, Asan Medical Center, Seoul, Korea
- 3Department of Gastroenterology, Inje University Ilsan Paik Hospital, Goyang, Korea
- 4Department of Gastroenterology, Yonsei University Gangnam Severance Hospital, Seoul, Korea
- 5Department of Gastroenterology, Inje University Busan Paik Hospital, Busan, Korea
- 6Department of Gastroenterology, Samsung Medical Center, Seoul, Korea
- 7Department of Gastroenterology, Yeungnam University Medical Center, Daegu, Korea
- 8Department of Gastroenterology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
- 9Department of Gastroenterology, Seoul National University Hospital, Seoul, Korea
- 10Department of Gastroenterology, Yonsei University Severance Hospital, Seoul, Korea
- 11Department of Gastroenterology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- 12Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
- 13Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
- 14National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
- 15Center for Gastric Cancer, National Cancer Center, Goyang, Korea
- 16Department of Gastroenterology, Chosun University Hospital, Gwangju, Korea
- 17Department of Gastroenterology, Cha University Bundang Medical Center, Seongnam, Korea
- 18Department of Gastroenterology, Jeonbuk National University Hospital, Jeonju, Korea
- 19Department of Gastroenterology, Korea University Anam Hospital, Seoul, Korea
Abstract
- Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
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