How to establish endoscopic submucosal dissection in Western countries

Table 2 Criteria of curative endoscopic resection en-bloc in esophagus, stomach, and colorectum (modified from[17])

Stomach

Guideline criteria1

m-ca, diff. type, ly (-), v (-), and Ul (-) and ≤ 2 cm in size

Expanded criteria2

m-ca, diff. type, ly (-), v (-), Ul (-) and any size > 2 cm

m-ca, diff. type, ly (-), v (-), Ul (+) and ≤ 3 cm in size

sm 1-ca (invasion depth < 500 μm3), diff. type, ly (-), v (-)

m-ca, undifferentiated type (G3), ly (-), v (-), Ul (-) and size < 2 cm

Esophagus (squamous lesions only)

Guideline criteria1

pT1a-EP-ca/pT1a-LPM-ca

Expanded criteria2

pT1a-MM-ca, ly (-), v (-), diff. type, expansive growth, ly (-), v (-)

cT1b-sm-ca (invasion < 200 μm3), ly (-), v (-), infiltrative growth pattern, expansive, diff. type, ly (-), v (-)

Colorectum

Guideline criteria1

m-ca, diff. type, ly (-), v (-)

sm-ca (< 1000 μm3), diff. type, ly (-), v (-)

¹Indications with risk of LNM < 1%;

²Indications with risk of LNM or systemic M < 4%;

³Measured as distance of maximum vertical invasion below MM. m: Mucosal; ca: Cancer; diff: Differentiated; ly: Lymphatic invasion; v: Vascular invasion; Ul: Ulceration; sm: Submucosal; EP: Epithelium; LPM: Lamina propria mucosae; MM: Muscularis mucosae.