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©The Author(s) 2021.
World J Gastrointest Oncol. Jun 15, 2021; 13(6): 560-573
Published online Jun 15, 2021. doi: 10.4251/wjgo.v13.i6.560
Published online Jun 15, 2021. doi: 10.4251/wjgo.v13.i6.560
Table 1 Absolute and expanded indications for endoscopic submucosal dissection in early gastric cancer patients in Japanese Gastric Cancer Association guideline version 4, 2014 and version 5, 2018
T1a | T1b | |||||||
UL (-) | UL (+) | SM1 (< 500 µm) | SM2 (> 500 µm) | |||||
≤ 2 cm | > 2 cm | ≤ 3 cm | > 3 cm | ≤ 3 cm | > 3 cm | ≤ 3 cm | > 3 cm | |
JGCA guideline (version 4, 2014) | ||||||||
Differentiated | ESD | EXPANDED(JCOG0607) | EXPANDED(JCOG0607) | SURGERY | EXPANDED | SURGERY | SURGERY | SURGERY |
Undifferentiated | EXPANDED | SURGERY | SURGERY | SURGERY | SURGERY | SURGERY | SURGERY | SURGERY |
JGCA guideline (version 5, 2018) | ||||||||
Differentiated | ESD | ESD | ESD | SURGERY | EXPANDED | SURGERY | SURGERY | SURGERY |
Undifferentiated | EXPANDED(JCOG1009/1010) | SURGERY | SURGERY | SURGERY | SURGERY | SURGERY | SURGERY | SURGERY |
Table 2 Curative and non-curative resection criteria for endoscopic submucosal dissection in early gastric cancer patients in Japanese Gastric Cancer Association guideline version 4, 2014 and version 5, 2018
T1a | T1b | |||||||
UL (-) | UL (+) | SM1 (< 500 µm) | SM2 (> 500 µm) | |||||
≤ 2 cm | > 2 cm | ≤ 3 cm | > 3 cm | ≤ 3 cm | > 3 cm | ≤ 3 cm | > 3 cm | |
JGCA guideline (version 4, 2014) | ||||||||
Differentiated | CR | CR | CR | NCR | CR | NCR | NCR | NCR |
Undifferentiated | CR | NCR | NCR | NCR | NCR | NCR | NCR | NCR |
JGCA guideline (version 5, 2018) | ||||||||
Differentiated | eCura A | eCura A | eCura A | eCura C | eCura B | eCura C | eCura C | eCura C |
Undifferentiated | eCura B | eCura C | eCura C | eCura C | eCura C | eCura C | eCura C | eCura C |
Table 3 eCura system for predicting lymph node metastasis rate of non-curative resection in early gastric cancer
Risk factor | Score | Risk grade | Total score1 | Lymph node metastasis rate (%) |
Tumor diameter > 3 cm | 1 | Low | 0-1 | 2.5 |
Submucosal invasion depth > 500 µm | 1 | Medium | 2-4 | 6.7 |
Lymphatic invasion positive | 3 | |||
Vascular invasion positive | 1 | High | 5-7 | 22.5 |
Vertical incisal margin positive | 1 |
Table 4 Differences and correlations between eCura system and eCura in Japanese Gastric Cancer Association guidelines version 5 in early gastric cancer
eCura system | eCura in JGCA guidelines version 5, 2018 | |
Evaluation index | Predicting LNM | Curative resection criteria |
Scope of application | Patients with EGC who do not meet the criteria of curative resection (eCura C2) | Patients with EGC who receive endoscopic resection |
Category | Low risk; medium risk; high risk | eCura A; eCura B; eCura C1; eCura C2 (using eCura system predicted LNM rate) |
- Citation: Zheng Z, Yin J, Liu XY, Yan XS, Xu R, Li MY, Cai J, Chen GY, Zhang J, Zhang ZT. Current indications for endoscopic submucosal dissection of early gastric cancer. World J Gastrointest Oncol 2021; 13(6): 560-573
- URL: https://www.wjgnet.com/1948-5204/full/v13/i6/560.htm
- DOI: https://dx.doi.org/10.4251/wjgo.v13.i6.560