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Current indications of endoscopic submucosal dissection for early gastric cancer in Japan.

Authors
  • Takizawa, Kohei1
  • Ono, Hiroyuki1
  • Muto, Manabu2
  • 1 Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan. , (Japan)
  • 2 Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. , (Japan)
Type
Published Article
Journal
Japanese Journal of Clinical Oncology
Publisher
Oxford University Press
Publication Date
Sep 01, 2019
Volume
49
Issue
9
Pages
797–802
Identifiers
DOI: 10.1093/jjco/hyz100
PMID: 31322655
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Endoscopic submucosal dissection for early gastric cancer seems to be technically mature. For expanding its indications, the outcomes of endoscopic submucosal dissection must not be inferior to those of surgery, as early gastric cancer is mostly treated by surgery. Therefore, the principles for the indications of endoscopic submucosal dissection are as follows: (1) extremely low possibility of lymph node metastasis as the theoretical condition and (2) suitability for an en-bloc resection as the technical condition. Based on previous positive results, differentiated gastric cancer (>2 cm without ulcer [UL]; ≤3 cm with UL) has become an absolute indication for endoscopic submucosal dissection. Undifferentiated gastric cancer is also expected to become an absolute indication in the future. Thereafter, the complete indications of endoscopic submucosal dissection for early gastric cancer will be available. Further, more expanded indication criteria should be considered especially for elderly patients because invasiveness of gastrectomy. © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected]

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