Early Gastric Cancer: Prediction of Metachronous Recurrence Using Endoscopic Submucosal Dissection (Methodology)
Although gastric cancer remains the second most common malignancy worldwide, its incidence and mortality has fallen dramatically during the last 50 years. Correa (1992) reported that the consequences of early gastric cancer (EGC) are comparatively good. Endoscopic treatment of EGC is being widely applied and carries with it some improvement for their prognosis; therefore, it was reported by Nagano et al. (2005) that many patients have been able to avoid open-surgery and maintain better quality of life. For these reasons, endoscopic resection of EGC is now the standard therapy in Japan and has been increasingly accepted and regularly used in other countries. Recently, Ono et al. (2001) reported that an innovational technique for endoscopic submucosal dissection (ESD) has been developed for en bloc resection. Toyonaga et al. (2006) reported that ESD has also made it possible to give an accurate diagnosis by pathological examination of EGC. On the other hand, it was reported by Hamanaka and Gotoda (2005) that endoscopic treatment excises only gastric carcinoma tissues, which implies that patients are still at risk of developing metachronous cancer from the remnant mucosa of the stomach. Therefore, molecular diagnosis is required for the screening of patients expected to have metachronous gastric carcinoma.
KeywordsGastric Cancer Endoscopic Submucosal Dissec Early Gastric Cancer Endoscopic Resection Microsatellite Instability
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