Endoscopic Techniques for Gastric Cancer Management
Summary
Endoscopic approaches have transformed the management of gastric cancer by enabling minimally invasive diagnosis, staging and curative treatment for early lesions. The two principal resection methods, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), permit removal of superficial neoplasms while preserving gastric function and reducing perioperative morbidity. Innovations in high-definition imaging, such as narrow-band imaging and magnifying endoscopy, have enhanced lesion characterisation and demarcation of resection margins. Endoscopic ultrasound and molecular markers complement visual assessment to inform staging and endoscopic curability. Emerging techniques—including traction devices, hybrid knives and coagulation forceps—streamline submucosal dissection and haemostasis. Integration of machine learning into risk stratification models promises refined prediction of lymph node involvement and tailored therapeutic decision-making. Together, these advances support a global shift towards organ-preserving strategies, shorter hospital stays and improved quality of life for patients with early gastric cancer.
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Endoscopic Techniques for Gastric Cancer Management publication trend
The graph below shows the total number of articles in endoscopic techniques for gastric cancer management across all publications each year (not limited to Nature Index journals).
Technical terms
Endoscopic submucosal dissection (ESD): A technique using specialised endoscopic knives to dissect the submucosal layer for en bloc removal of early gastric neoplasms.
Endoscopic mucosal resection (EMR): A method that deploys snares or cap-assisted devices to excise mucosal lesions, often in piecemeal fashion for smaller or less invasive tumours.
En bloc resection: The removal of a lesion in a single specimen, crucial for accurate histopathological assessment and reduced local recurrence.
Early gastric cancer (EGC): Carcinoma confined to the mucosa or submucosa of the stomach, irrespective of nodal status, for which endoscopic cure is feasible.
Lymph node metastasis (LNM): Spread of cancer cells from the primary gastric lesion to regional lymph nodes, a key determinant of therapeutic strategy.
References
- A machine learning model for predicting the lymph node metastasis of early gastric cancer not meeting the endoscopic curability criteria. Gastric Cancer (2024).
- Endoscopic Resection Compared with Gastrectomy to Treat Early Gastric Cancer: A Systematic Review and Meta-Analysis. PLOS ONE (2015).
- The Comparison between Endoscopic Submucosal Dissection and Surgery in Gastric Cancer: A Systematic Review and Meta‐Analysis. Gastroenterology Research and Practice (2018).
- Long‐Term Clinical Efficacy and Perioperative Safety of Endoscopic Submucosal Dissection versus Endoscopic Mucosal Resection for Early Gastric Cancer: An Updated Meta‐Analysis. BioMed Research International (2018).
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