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Korean Association for the Study of Intestinal Diseases, Intestinal Research, 2(19), p. 127-157, 2021

DOI: 10.5217/ir.2020.00020

BioMed Central, Taehan Sohwaki Py¿¿¿¿ng Hakhoe Chapji, 5(75), p. 264-291, 2020

DOI: 10.4166/kjg.2020.75.5.264

The Korean Journal of Helicobacter and Upper Gastrointestinal Research, 2020

DOI: 10.7704/kjhugr.2020.0023

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Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by <i>en bloc</i> fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly <i>de novo</i> methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.