| [ Summary ] |
Indications for endoscopic mucosal resection (EMR) of early gastric cancer were standardized by the gastric cancer treatment guidelines (GL). It is though that GL should clarify the indications for EMR, the valuation basis for curative potential and post EMR guidelines. The indications for EMR were considered to be appropriate, minimal standards. The evaluation of the curative potential of EMR must be based on histological findings with careful consideration of the risks of residual tumor tissue and lymph node metastasis. Post EMR guidelines should correspond with the curative potential. The following are our criteria for curative resection, (1) intramucosal cancer, differentiated adenocarcinoma, irrespective of size, without ulcerative findings, without lymphatic venous invasion, (2) intramucosal cancer, differentiated adenocarcinoma, less than 3cm in size, with ulcerative findings, and no lymphatic venous invasion. Lesions that satisfy these criteria are indicators of a low risk of lymph node metastasis. In the future, it may be possible to extend the indications for the following lesions, (1) minute submucosal cancer (SM1), differentiated adenocar cinoma, less than 3cm in size, without lymphatic venous invasion, (2) intramucosal cancer, undifferentiated carcinoma, less than 3cm in size, without ulcerative findings, without lymphatic venous invasion. |