Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

• Published in: Clinical endoscopy Vol. 53; no. 2; pp. 142 - 166
• Main Authors: Park, Chan Hyuk, Yang, Dong-Hoon, Kim, Jong Wook, Kim, Jie-Hyun, Kim, Ji Hyun, Min, Yang Won, Lee, Si Hyung, Bae, Jung Ho, Chung, Hyunsoo, Choi, Kee Don, Park, Jun Chul, Lee, Hyuk, Kwak, Min-Seob, Kim, Bun, Lee, Hyun Jung, Lee, Hye Seung, Choi, Miyoung, Park, Dong-Ah, Lee, Jong Yeul, Byeon, Jeong-Sik, Park, Chan Guk, Cho, Joo Young, Lee, Soo Teik, Chun, Hoon Jai
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Gastrointestinal Endoscopy 01.03.2020; 대한소화기내시경학회
• Subjects: early colorectal cancer; early gastric cancer; endoscopic resection; guideline; Review; superficial esophageal squamous cell carcinoma; 내과학; Guideline; Superficial esophageal squamous cell carcinoma; Endoscopic resection; Early gastric cancer; Early colorectal cancer
• ISSN: 2234-2400; 2234-2443
• DOI: 10.5946/ce.2020.032

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 en bloc 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 de novo 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.