Expansion of Indication for Endoscopic SD in Early Gastric Cancer

Do Hoon Kim; Hwoon-Yong Jung

doi:10.5230/jgc.2010.10.2.49

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Kim and Jung: Expansion of Indication for Endoscopic SD in Early Gastric Cancer

Review Article

Journal of Gastric Cancer

Journal of Gastric Cancer 2010; 10(2): 49-54.

Published online: 30 June 2010

DOI: https://doi.org/10.5230/jgc.2010.10.2.49

Expansion of Indication for Endoscopic SD in Early Gastric Cancer

Do Hoon Kim, Hwoon-Yong Jung

Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.

Correspondence to: Hwoon-Yong Jung. Department of Internal Medicine, Institute of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap 2-dong, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3197, Fax: +82-2-485-5782, hwoonymd@gmail.com

Received 1 June 2010 Accepted 3 June 2010

Abstract

Endoscopic resection is now accepted as curative treatment modalities for early gastric cancer without lymph node metastasis. However, based on large-scaled data about the risk of lymph node metastasis in early gastric cancer and as a result of the technical development of endoscopic devices, it was suggested that the criteria for endoscopic resection should be extended. According to the treatment guidelines for gastric cancer in Japan, the extended indications include the following: differentiated-type mucosal cancer without ulceration and greater than 2 cm in diameter, differentiated-type mucosal cancer with ulceration and up to 3 cm in diameter, undifferentiated-type mucosal cancer without ulceration and up to 2 cm in diameter, and, in the absence of lymphovascular invasion, a tumor not deeper than submucosal level 1 (less than 500 µm). In this review, we discuss the evidence of the application of expanded endoscopic indication based on analysis of biologic behavior and data of endoscopic resection.

Keywords: Early gastric cancer, Endoscopic submucosal dissection, Expanded indication

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ORCID iDs: Hwoon-Yong Jung
https://orcid.org/http://orcid.org/0000-0003-1281-5859
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