Important considerations when contemplating endoscopic resection of undifferentiated-type early gastric cancer

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MeSH: Algorithms ; Biopsy ; Cell Differentiation* ; Decision Support Techniques ; Disease-Free Survival ; Gastrectomy/adverse effects ; Gastrectomy/methods* ; Gastrectomy/mortality ; Gastroscopy/adverse effects ; Gastroscopy/mortality ; Humans ; Neoplasm Staging ; Patient Selection ; Predictive Value of Tests ; Quality of Life ; Risk Assessment ; Risk Factors ; Stomach Neoplasms/diagnostic imaging ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Treatment Outcome

Keywords: Early gastric cancer ; Endoscopic resection ; Lymph node metastasis ; Undifferentiated

Abstract: Endoscopic resection (ER) of undifferentiated-type early gastric cancer (UD-EGC) has a lower curative resection (CR) rate than does ER of differentiated-type EGC (D-EGC). However, a low CR rate does not mean that it is unreasonable to schedule ER of UD-EGC. If ER is in fact curative, the long-term outcomes including survival rate are excellent. Quality of life is good because maximal stomach preservation is possible. However, UD-EGC and D-EGC differ histologically. Thus, when ER is contemplated to treat UD-EGC, a careful approach employing strict criteria is essential because the biology of UD-EGC and D-EGC differ.