Rossi G, Petrone MC, Healey AJ, Arcidiacono PG. Gastric cancer in 2022: Is there still a role for endoscopic ultrasound? World J Gastrointest Endosc 2023; 15(1): 1-9 [PMID: 36686065 DOI: 10.4253/wjge.v15.i1.1]
Corresponding Author of This Article
Gemma Rossi, MD, Consultant Physician-Scientist, Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita Salute San Raffaele University, Olgettina Str. 60, Milan 20132, Italy. rossi.gemma@hsr.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jan 16, 2023; 15(1): 1-9 Published online Jan 16, 2023. doi: 10.4253/wjge.v15.i1.1
Gastric cancer in 2022: Is there still a role for endoscopic ultrasound?
Gemma Rossi, Maria Chiara Petrone, Andrew J Healey, Paolo Giorgio Arcidiacono
Gemma Rossi, Maria Chiara Petrone, Paolo Giorgio Arcidiacono, Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita Salute San Raffaele University, Milan 20132, Italy
Andrew J Healey, Department of Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, United Kingdom
Author contributions: Rossi G substantially contributed to conception and design of the study, acquisition of data, or analysis and interpretation of data, drafted the article or made critical revisions related to important intellectual content of the manuscript; Petrone MC and Healey A drafted the article or making critical revisions related to important intellectual content of the manuscript; Arcidiacono PG finally approved of the version of the article to be published; all authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors have not conflict-of-interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gemma Rossi, MD, Consultant Physician-Scientist, Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita Salute San Raffaele University, Olgettina Str. 60, Milan 20132, Italy. rossi.gemma@hsr.it
Received: October 3, 2022 Peer-review started: October 3, 2022 First decision: November 2, 2022 Revised: November 7, 2022 Accepted: December 21, 2022 Article in press: December 21, 2022 Published online: January 16, 2023
Abstract
Gastric cancer (GC) represents the fourth leading cause of cancer death worldwide and many factors can influence its development (diet, geographic area, genetic, Helicobacter pylori or Epstein-Barr virus infections). High quality endoscopy represents the modality of choice for GC diagnosis. The correct morphologic classification during a high-resolution endoscopy is fundamental for oncologic diagnosis, staging and therapeutic decisions. Since its initial introduction in clinical practice the endoscopic ultrasound (EUS) has been considered a valuable tool for tumor (T-) and lymph nodes (N-) staging also in GC, in order to establish the best therapeutic strategy for the patient (e.g., upfront surgery vs neoadjuvant treatments). EUS tools as elastography, Doppler and contrast administration can improve diagnosis mainly in case of malignant lymph node evaluation. EUS has a marginal role in disease staging but has a fundamental role in case of a pre-endoscopic resection management and in the new era of endoscopic mucosal resection or submucosal dissection as minimally invasive surgery. Diagnosis and locoregional staging of GC with EUS are a method of inarguable value for the assessment of gastric wall involvement and presence of infiltrated paragastric lymph nodes. EUS can also have a role in disease restaging in those patients who have undergone neoadjuvant treatment. EUS can also have a role in the advanced phases of the disease, in facilitating palliative, minimally-invasive treatments, such as gastroenterostomy or biliary drainages. This review intends to discuss the modern role of EUS in GC topic.
Core Tip: Since its initial introduction in clinical practice endoscopic ultrasound has been considered a valuable tool for tumor and lymph nodes staging of gastric cancer, in order to establish the best therapeutic strategy for the patient. Moreover, in this new era of endoscopic mucosal resection or submucosal dissection and minimally invasive surgery, endoscopic ultrasound is increasingly important for early gastric cancer staging and therapeutic decision making and it can also have a role in the advanced phases of the disease, in facilitating palliative, minimally-invasive treatments.
