Treatment Strategies after Non-curative Endoscopic Resection of Early Gastric Cancer.
10.4166/kjg.2017.70.3.128
- Author:
Shin Hee KIM
1
;
Su Jin HONG
Author Information
1. Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea. sjhong@schmc.ac.kr
- Publication Type:Review
- Keywords:
Gastric cancers;
Endoscopic submucosal dissection;
Residual tumors;
Lymphatic metastasis;
Therapeutics
- MeSH:
Aged;
Argon;
Gastrectomy;
Humans;
Lymph Node Excision;
Lymph Nodes;
Lymphatic Metastasis;
Neoplasm Metastasis;
Neoplasm, Residual;
Recurrence;
Stomach Neoplasms*
- From:The Korean Journal of Gastroenterology
2017;70(3):128-133
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The cases of non-curative endoscopic resection (NCR) of early gastric cancer have increased due to the widespread use of endoscopic submucosal dissection (ESD). NCR is associated with augmenting chances of local recurrence and lymph node metastasis (LNM). Therefore, some additional treatment strategies after NCR are needed. Treatment strategies for NCR should be determined by considering the risk of residual tumor or local recurrence and LNM. Additional surgical treatment such as gastrectomy and lymph node dissection are recommended in patients who have high-risk of LNM. Close observation without additional treatment is considered for selected patients with a less possibility of local recurrence or LNM. Also it may be suggested if there is no or less benefit from surgery in elderly patients or patients with underlying diseases. Additional endoscopic procedures including ESD, endoscopic mucosal resection or argon coagulation therapy are suggested alternatively for highly selected patients not at risk of LNM based on the absolute or expanded criteria of ESD.
