Early gastric carcinoma - Endoscopic therapy

Endoscopic removal of early gastric cancers is limited to low-risk situations: T1m ( = mucosa) L0 V0 G1-2 R0. The neoplastic lesion will be removed endoscopically. In case of histologically proven low-risk criteria, this therapeutic procedure is curative. Extended indications include T1sm1 L0 V0 G1-2 with a cut-off limit of 500 μm in the submucosa level and T1m L0 V0 G3 in case of small tumors (≤2-3 cm). The complication rate of endoscopic procedures is low (10%), the mortality rate near 0%. The endoscopic treatment should be limited to specialized interdisciplinary centers. When compared with oncological surgical resection procedures, local endoscopic therapeutic procedures are loaded with increased rates of local recurrency (2%), metachronic (4%) and synchronic neoplastic lesions (10%) and include a low potential risk of metastatic disease (<1%).