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World J Gastrointest Endosc. Sep 10, 2015; 7(12): 1062-1069
Published online Sep 10, 2015. doi: 10.4253/wjge.v7.i12.1062
Treatment modalities for early gastric cancer
Jesús Espinel, Eugenia Pinedo, Vanesa Ojeda, Maria Guerra del Rio
Jesús Espinel, Department of Digestive Diseases, Hospital Universitario de León, 24071 León, Spain
Eugenia Pinedo, Department of Radiodiagnosis, Hospital Universitario de León, 24071 León, Spain
Vanesa Ojeda, Department of Digestive Diseases, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, 35010 Canaria, Spain
Maria Guerra del Rio, Burton Hospitals NHS Foundation Trust, Burton on Trent, Staffordshire DE13 0RB, United Kingdom
Author contributions: All authors contributed equally to the paper.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: 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/
Correspondence to: Jesús Espinel, MD, Department of Digestive Diseases, Hospital Universitario de León, C/Altos de Nava, s/n, 24071 León, Spain. espinel.jesus@gmail.com
Telephone: +34-987-237400 Fax: +34-987-235318
Received: April 25, 2015
Peer-review started: April 26, 2015
First decision: June 2, 2015
Revised: June 17, 2015
Accepted: August 25, 2015
Article in press: August 28, 2015
Published online: September 10, 2015
Processing time: 138 Days and 16 Hours
Abstract

Different treatment modalities have been proposed in the treatment of early gastric cancer (EGC). Endoscopic resection (ER) is an established treatment that allows curative treatment, in selected cases. In addition, ER allows for an accurate histological staging, which is crucial when deciding on the best treatment option for EGC. Recently, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have become alternatives to surgery in early gastric cancer, mainly in Asian countries. Patients with “standard” criteria can be successfully treated by EMR techniques. Those who meet “expanded” criteria may benefit from treatment by ESD, reducing the need for surgery. Standardized ESD training system is imperative to promulgate effective and safe ESD technique to practices with limited expertise. Although endoscopic resection is an option in patients with EGC, surgical treatment continues to be a widespread therapeutic option worldwide. In this review we tried to point out the treatment modalities for early gastric cancer.

Keywords: Early gastric cancer; Endoscopic submucosal dissection; Endoscopic mucosal resection; Pathological staging; Gastrectomy

Core tip: Gastric cancer is one of the main causes of cancer death. For early gastric cancer (EGC) endoscopic resection is an effective treatment modality for selected cases of EGC. Endoscopic submucosal dissection is designed to provide en bloc R0 resection regardless of size. Gastrectomy is the standard treatment for EGC with suspected lymph node metastases. This review describes the current different treatment modalities for early gastric cancer.