Review Article
A Murillo-Zolezzi, H Mascare&n
Abstract
Gastric cancer, which once was the most common type of cancer, still afflicts a great proportion of the population. There is a tendency towards improving outcomes in regards to mortality, through a greater understanding of tumor biology and particularly its association with Helicobacter pylori infection. However, 5-year survival, in general, is still poor (20%). One of the most important areas of opportunity in the treatment of this disease, particularly in high incidence countries and in at-risk individuals is early detection of the disease. If this is achieved the individual is a candidate for a diverse set of organ saving interventions which are minimally invasive and achieve excellent long term results. The purpose of this review article is to analyze endoscopic resection as a treatment for early gastric cancer, describing the two most common techniques: Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD), their characteristics and results. Both of them, alone or in a hybrid-modality could be curative in selected patients with low risk for nodal metastases, without the implications and complications of a gastrectomy. Albeit these are excellent treatment options, there are concerns regarding incomplete resections, lack of expertise, procedural complications and still lack of follow up surveillance criteria. Further research is needed before recommending endoscopic resection as the first line therapy for early gastric cancer