Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13273
Revised: February 10, 2014
Accepted: April 30, 2014
Published online: October 7, 2014
Core tip: Endoscopic treatment of early gastric cancer (EGC) has been evolved along with the expansion of ESD indication and toward the question of how to achieve accurate risk assessment of lymph node metastasis (LNM). To achieve curative endoscopic treatment, not only accurate endoscopic diagnosis but precise selection of the patient of EGC without LNM should be preceded. Recently, endomicroscopy has been introduced to provide precise microscopic visualization of histology. Moreover, sentinel node navigation surgery combined ESD and hybrid natural orifice transluminal endoscopic surgery have been reported as a new minimally invasive treatment option for the EGC patients with high risk of LNM.