Endoscopic resection of early gastric cancer: current status and new approaches

Ko, Weon Jin; Song, Ga Won; Kim, Wonhee; Hong, Sung Pyo; Cho, Joo Young

doi:10.21037/tgh.2016.03.22

Cited by 25 publications

(18 citation statements)

References 44 publications

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“…3 A major limitation of EMR is incomplete resection of lesions >2 cm due to size limitation of the instruments used. 46 While in ESD, the mucosa surrounding the lesion is circumferentially incised using a high-frequency electric knife and the submucosal layer is dissected from the proper muscle layer. 3 The size limitation in EMR is addressed by ESD and is considered superior to EMR because it enables precise pathologic T staging for large EGC.…”

Section: Endoscopic Resectionmentioning

confidence: 99%

“…3 The size limitation in EMR is addressed by ESD and is considered superior to EMR because it enables precise pathologic T staging for large EGC. 46 In a recent metaanalysis, 47 ESD was shown to have advantages in en bloc resection, histologically complete resection, and local recurrence rate compared to EMR. Although mean operation time and complications such as perforation was higher in the ESD technique.…”

Section: Endoscopic Resectionmentioning

confidence: 99%

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Function-Preserving Surgery in Gastric Cancer

Bueno

Park

Ahn

et al. 2018

J Minim Invasive Surg

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The rising incidence of early gastric cancer has enabled the development of function-preserving gastrectomy with the focus on post gastrectomy quality of life and adherence to sound oncologic principles. It is concurrent with the growing popularity of minimally invasive surgery; and both are commonly used together. The different kinds of function-preserving gastrectomy included in this review are: pylorus-preserving and proximal gastrectomy, vagus nerve preservation, sentinel node navigation, and various endoscopic & minimally-invasive techniques. In this article the indications, techniques, oncologic safety, functional benefit, and outcomes of each kind of function-preserving gastrectomy are discussed.

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Section: Endoscopic Resectionmentioning

confidence: 99%

Section: Endoscopic Resectionmentioning

confidence: 99%

Function-Preserving Surgery in Gastric Cancer

Bueno

Park

Ahn

et al. 2018

J Minim Invasive Surg

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“…The main target of endoscopic therapy is limited to the differentiated type in EGCs [20,21]; however, recent studies have shown that endoscopic therapy can also be applied to some undifferentiated types (< 10 mm in diameter and IMC) in Japan [22,23]. Moreover, in routine practice, differentiated-type GC accounts for approximately 60% of all EGCs [24], and the detection rate for MIMN s has been reported to exceed 80% [24].…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological and Molecular Findings of Differentiated-Type Minute Gastric Intramucosal Neoplasia

et al. 2019

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Background/Aims: To evaluate gastric early differentiatetype carcinogenesis, we attempted to identify clinicopathological and biological differences in differentiated-type minute intramucosal neoplasia (MIMN), which was defined as a tumor with a diameter of < 5 mm. Methods: We examined clinicopathological findings and biological factors, including TP53 overexpression, mucin phenotype, Ki-67-positive rate, MLH1, intranuclear accumulation of β-catenin, and DNA methylation status (low methylation epigenotype [LME], intermediate methylation epigenotype, and high methylation epigenotype [HME]) in MIMNs. In addition, non-MIMNs were also analyzed. In the present study, MIMN and non-MIMN were also examined based on low-grade dysplasia, highgrade dysplasia, and intramucosal cancer (IMC). Results: In clinicopathological findings, there were significant differences in sex ratios and tumor locations between MIMNs and non-MIMNs. Among the examined biological factors, no significant differences in the frequencies of biological factors were observed between the 2 intramucosal neoplasia types. However, the frequency of intranuclear accumulation of β-catenin was higher in non-MIMNs than in MIMNs. Finally, although the frequency of HME was significantly lower in MIMNs than in non-MIMNs, the opposite was observed for LME. Conclusions: The current finding suggested that DNA methylation and accumulation of β-catenin were closely associated with tumor development from MIMN to non-MIMN.

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“…Endoscopic dissection is now acknowledged as a curative therapy for gastrointestinal polyps, adenomas, and early cancer . Derivative peroral endoscopic myotomy (POEM) and submucosal tunneling endoscopic resection (STER) are minimally invasive and effective in the treatment of achalasia and submucosal tumors.…”

Section: Introductionmentioning

confidence: 99%

“…E NDOSCOPIC DISSECTION IS now acknowledged as a curative therapy for gastrointestinal polyps, adenomas, and early cancer. 1,2 Derivative peroral endoscopic myotomy (POEM) and submucosal tunneling endoscopic resection (STER) are minimally invasive and effective in the treatment of achalasia and submucosal tumors. Different from laparoscopy, endoscopic operation is flexible and works around the thin gastrointestinal mucosa.…”

Section: Introductionmentioning

confidence: 99%