Current Status of Endoscopic Resection of Early Gastric Cancer in Korea

Hwoon-Yong Jung

doi:10.4166/kjg.2017.70.3.121

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Jung: Current Status of Endoscopic Resection of Early Gastric Cancer in Korea

Review Article

Korean J Gastroenterol 2017;70(3):121-127.

Published online: 4 October 2017

DOI: https://doi.org/10.4166/kjg.2017.70.3.121

Current Status of Endoscopic Resection of Early Gastric Cancer in Korea

Hwoon-Yong Jung

Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence to: Hwoon-Yong Jung, Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-3180, Fax: +82-2-476-0824, E-mail: hwoonymd@gmail.com

Received 29 August 2017 Revised 16 September 2017 Accepted 16 September 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Endoscopic resection (Endoscopic mucosal resection [EMR] and endoscopic submucosal dissection [ESD]) is already established as a first-line treatment modality for selected early gastric cancer (EGC). In Korea, the number of endoscopic resection of EGC was explosively increased because of a National Cancer Screening Program and development of devices and techniques. There were many reports on the short-term and long-term outcomes after endoscopic resection in patients with EGC. Long-term outcome in terms of recurrence and death is excellent in both absolute and selected expanded criteria. Furthermore, endoscopic resection might be positioned as primary treatment modality replacing surgical gastrectomy. To obtain these results, selection of patients, perfect en bloc procedure, thorough pathological examination of resected specimen, accurate interpretation of whole process of endoscopic resection, and rational strategy for follow-up is necessary.

Keywords: Gastric cancer, Endoscopic submucosal dissection, Endoscopic mucosal resection

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Table 1.

Long-term Outcomes of Endoscopic Resection Compared with Surgical Gastrectomy in Korea

	Patients (ER/Op)	FU period (m)	Local recurrence (%) ER/Op	Metachronous recurrence (%) ER/Op	Distant metastasis (%) ER/Op	Overall 5-YSR (%) ER/Op	Disease-specific 5-YSR (%) ER/Op
Choi et al. (2011)³⁹	551 (172/379)	81	1.2/1.1	5.8/1.1	0/0	93.6/94.2	98.7/99.7
Choi et al. (2015)⁴⁸	375 (261/114)	76.4	0/0	6.1/0.9	0/0	95.7/93.6	N/A
Kim et al. (2015)⁴⁹	457 (165/292)	58.6	0/0.3	5.5/0	0/0	97.5/97.0	N/A
Ryu et al. (2016)⁵⁰	225 (41/144)	N/A	4.9/1.4	6.2/0.7	0/0	100/100	85/97
Pyo et al. (2016)⁵¹	2,563 (1290/1273)	46	0.7/0	5.4/0.8	0.5/0.4	97.1/96.3	99.6/99.4
Cho et al. (2016)⁵²	461 (288/173)	78	1.7/0	4.9/0	0/0.6	92.0/90.2	N/A
Chang et al. (2017)⁵³	153 (74/79)	N/A	1.4/0	2.7/0	0/0	95.8/95.6	100/98.4
Gong et al. (2017)⁵⁴	79 (40/39)	60.9	0/0	7.5/0	0/0	93.9/97.3	N/A

ER, endoscopic resection; Op, surgical gastrectomy; FU, follow-up; 5-YSR, 5 year survival rate; N/A, not available.

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